170: A League of Their Own: Advancements in UCL Surgery

Modern Surgical Management of Elbow UCL TearsLive from the Arthrex Team Physician Controversies  🎧 Episode SummaryIn this episode of The Sports Docs Podcast, Dr. Ashley Bassett and Dr. Catherine Logan sit down LIVE from the Arthrex Team Physician Controversies with two leaders in sports medicine—Dr. Neal ElAttrache and Dr. Jeffrey Dugas—to discuss the modern management of ulnar collateral ligament (UCL) injuries in throwing athletes.HighlightsChanging UCL Injury Landscape Increasing incidence of UCL injuries and surgeries across all levels of play  Notable rise in adolescent and collegiate pitchers Contributing factors include year-round play and high pitch velocity Nonoperative Management & Role of PRP Nonoperative treatment remains appropriate for select partial tears  Success varies based on tear grade and locationPRP discussed as an adjunct to rehabIndications for Surgery Complete tears—especially in competitive throwers—often require surgical intervention  Tear characteristics (location, tissue quality, chronicity) are critical in decision-making UCL Repair with Internal Brace Increasingly utilized in appropriately selected patients Ideal candidates:  Acute injuries  Proximal or distal avulsion tears  Good tissue quality  Advantages:  High return-to-play (~90%+) Accelerated recovery timelines (often several months faster) UCL Reconstruction (Tommy John Surgery) Remains the gold standard for:  Chronic degeneration  Midsubstance tears  Revision cases  Techniques have evolved over time:  Docking technique  Figure-of-eight  Newer fixation methods (e.g., cortical button techniques)  Autograft (commonly palmaris longus) remains preferred in elite throwers Internal Brace Technology Provides added stability and resistance to valgus stress  Supports early rehabilitation while protecting healing tissue  Increasing use in both repair and, selectively, reconstruction Key Takeaways UCL injuries are increasing, particularly in younger athletes  Treatment decisions are increasingly personalized based on tear type and athlete profile UCL repair with Internal Brace is shifting the paradigm for select patients  Reconstruction remains essential for more complex or chronic injuries Featured GuestsDr. Neal ElAttrache – Kerlan-Jobe Orthopaedic Clinic, Head Team Physician for the LA Dodgers & LA Rams Dr. Jeffrey Dugas – Andrews Sports Medicine & Orthopaedic Center, leading expert in UCL repair and reconstruction 🎤 Stay ConnectedIf you enjoyed this episode, be sure to subscribe, rate, and review on:Apple Podcasts | Spotify | Amazon Music | YouTubeFollow us on Instagram