The Difficulties of Assessing Return to Play and Return to Performance after UCL Reconstruction

Abstract

Ulnar collateral ligaments (UCL) tears have moved from a career ending injury to one where success is almost expected from reconstruction. In reality, though, success from a UCL reconstruction is not guaranteed. As we have attempted to assess the true success rate of UCL reconstructions we have also learned the difficulties of this assessment. Rates of return to sport after ulnar collateral ligament reconstruction vary by level of play, the primary or revision status of the repair along with the specific surgical techniques performed, the chronicity of the tear, the rehab protocols associated with the surgery, and more. Return to sport is difficult to assess as high school, collegiate and even professional careers can be variable and there are no standard definitions of “returning to play”. These variables also affect our assessments of performance after UCL reconstruction. Decisions for UCL reconstructions and appropriate counseling of patients regarding the likelihood of success currently remains an individual process.