Arthroscopic and Open Radial Ulnohumeral Ligament Reconstruction for Posterolateral Rotatory Instability of the Elbow

Arthroscopic repair and/or plication of the radial ulnohumeral ligament (RUHL) complex can be as successful as open repair. The diagnosis of posterolateral rotatory instability (PLRI), made by a combination of positive clinical findings and radiologic evidence, can be confirmed by arthroscopic examination. The authors describe four clinical tests for PLRI. Magnetic resonance arthrography is recommended to assist in the preoperative evaluation. In surgical cases, the means to arthroscopically confirm instability are explained. Finally, the authors describe a repair and a ligament plication technique that can be performed by either arthroscopic or open technique with a high rate of success. Arthroscopic repair/plication of the RUHL is thought to effectively stabilize an elbow with PLRI, producing a high degree of patient satisfaction.