Background: Medial ulnar collateral ligament (UCL) injuries are functionally debilitating for throwing and overhead athletes. While autograft remains the most common graft for UCL reconstruction (UCLR), allograft offers advantages, including reduced donor-site morbidity and reduced surgical time. However, clinical outcome data on allograft use, particularly in overhead athletes, remain limited. Hypothesis: It was hypothesized that overhead athletes undergoing UCLR with hamstring allograft would demonstrate high return to sport (RTS) rates, favorable functional and patient-reported outcomes, and low complication rates. Study Design: Case series; Level of evidence, 4. Methods: This retrospective case series evaluated 25 overhead athletes who underwent UCLR using hamstring allograft between 2017 and 2022 at a single, high-volume orthopaedic practice. Patient-reported outcome measures were collected at baseline and at a minimum 1-year follow-up, including the 12-Item Short Form Health Survey, Veterans RAND 12-Item Health Survey, Patient-Reported Outcomes Measurement Information System Upper Extremity (PROMIS UE), Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) score, Mayo Elbow Performance Score (MEPS), and visual analog scale (VAS) for pain. Functional outcomes (grip strength and range of motion ROM), RTS, and complications were assessed at a minimum of 1-year follow-up. Results: The cohort's mean age was 21 years, and 80% were men. Overall, RTS (48% highschool, 48% collegiate, 4% professional)was achieved in 92% of patients, with 83% returning to their previous or higher level of sport. At final follow-up (mean, 13 ± 19 months), the mean postoperative PROMIS UE was 59.2, QuickDASH was 5.6, MEPS was 72.5, and VAS Pain was 4.7. ROM returned to preoperative levels or improved in all but one patient. Failure resulting in revision reconstruction occurred in 1 patient. Two patients underwent hardware removal, and 1 patient had continued subjective instability. No infections or graft rejections occurred. Conclusion: At 1-year follow-up, UCLR with hamstring allograft demonstrates high RTS rates and favorable functional and patient-reported outcomes in overhead athletes, with a low complication rate.
Moews et al. (Sun,) studied this question.