Are Suture Spanning Repair Techniques Replacing Traditional Tommy John Surgery? Prevalence and Complication Rates Following Ulnar Collateral Ligament Repair or Reconstruction.

Background: Ulnar collateral ligament (UCL) reconstruction has historically been considered the gold standard treatment for severe UCL tears. With the advent of suture-spanning repair techniques, some studies suggest that UCL repair is being performed with increasing frequency. This study provides a large analysis of UCL reconstruction versus repair trends in the United States following the introduction of suture-spanning repair techniques. Purpose: To compare the prevalence and complication rates of UCL reconstruction versus repair over a 5-year span following the introduction of suture spanning repair techniques. We also sought to determine if there was an age-related preference for reconstruction versus repair and whether the addition of an ulnar nerve transposition (UNT) affected short-term complication rates. Study Design: Cohort study; Level of evidence, 3. Methods: Using the Merative MarketScan research databases, which contain deidentified patient national claims information, we retrospectively identified patients aged 14 to 30 years who underwent UCL reconstruction or repair between 2016 and 2021, with or without UNT. Patients with a fracture diagnosis at the time of surgery were excluded. Demographic information including age, sex, and geographic region was collected. The number of patients who experienced infection, ulnar neuropathy, device-related complications, and unspecified complications were obtained for each procedure. Results: A total of 1191 reconstruction patients and 696 repair patients were identified. 36.8% of patients who underwent either reconstruction or repair had a concomitant UNT. UCL reconstruction patients were approximately 3 years older than repair patients on average ( Conclusion: Between 2016 and 2021, following the introduction of suture spanning UCL repair techniques, the number of UCL repairs increased and the number of reconstructions decreased. There was no difference in complication rates between UCL repair and UCL reconstruction and the rate of complication for either surgery remains low.