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The Mini-open Plication of Medial Collateral Ligament of the Elbow

A New Arthroscopically Assisted Technique

Lesman, Jędrzej MD*; Luceri, Francesco MD; Domżalski, Marcin MD, PhD*; Randelli, Pietro S. MD, PhD; Arrigoni, Paolo MD, PhD

Techniques in Shoulder & Elbow Surgery: December 2019 - Volume 20 - Issue 4 - p 121–124
doi: 10.1097/BTE.0000000000000176

The stability of the medial elbow compartment is not only important for everyday life but also plays a key role in throwing gestures. Valgus stress is a fundamental part of popular sport activities (baseball, squash, tennis, and volleyball). Even the isolated medial collateral ligament (MCL) lesion might develop symptomatic medial instability, which interrupts everyday life. This instability may be symptomatic and patients may refer medial elbow pain. Several techniques for MCL treatment have been described. Most of them are reconstructions in which there are tunnels and free cylindrical grafts. The aim of our study is to describe step-by-step a new surgical procedure for minimally invasive plication of aMCL arthroscopically assisted. This procedure should be performed after 6 months of conservative treatment failure. After arthroscopic MCL laxity diagnosis, the standard bioabsorbable double-loaded anchor with high resistance sutures was inserted into the anteroinferior surface of the medial epicondyle. After adequate restraint and preparation of proximal aMCL, 2 bioresorbable sutures were passed through the ligament considering 1 to 1.5 cm of tissue to be plicated. The procedure is considered less invasive and safe in comparison with graft reconstructions of MCL.

*Clinic of Orthopedics, Medical University of Łódź, Łódź, Poland

Laboratory of Applied Biomechanics, Department of Biomedical Sciences for Health, University of Milano, Italy

The authors declare no conflict of interest.

Reprints: Jędrzej Lesman, MD, Żeromskiego 113 ST, 90-549 Łódź, Poland (e-mail:

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