Surgical Repair of Posterolateral Rotatory Instability of the Elbow Using Surgilig/LockDown: A Novel Surgical Technique

Posterolateral rotatory instability (PLRI) of the elbow is the most common type of chronic elbow instability and is principally due to lateral ulnar collateral ligament injury. We describe a novel surgical technique for the treatment of PLRI using the Surgilig/ LockDown. Using this tensioned double-braided polyester synthetic ligament to reconstruct the lateral ulnar collateral ligament it is possible to reconstitute elbow stability. Through a global posterior midline incision, a Surgilig/LockDown synthetic ligament is first secured to the proximal ulnar and then passed through a bone tunnel from the isometric point of the lateral epicondyle, along the lateral column, exiting the posterior aspect of the supracondylar ridge where it is tensioned and secured with bicortical screw fixation. We present 2 cases where Surgilig has been used to treat PLRI in a primary and revision scenario. Our early findings have found that this method confers good elbow stability and immediate motion without the need for allograft harvesting or multiple tendon routing in both primary and revision reconstruction of the elbow.