Ligaments are connective tissues made up of strong collagen fibres. The main function of a ligament is to connect and hold two bones together, especially at the joint. Given their connective feature, ligaments are vital in the stabilisation of joints, preventing dislocations, and hyper-movements that result in sprains. 

Particularly at the elbow, ligaments play the role of arm stability as they hold bones such as the humerus and ulna in place. Where ligaments are torn or ruptured, an elbow ligament reconstruction is necessary. An elbow ligament reconstruction is a surgical intervention that aims to replace torn ligaments with grafted tendons. The objective of an elbow ligament reconstruction surgery is to restore mobility and functionality of the joint. 

It is important to note that not all ligament tears require reconstruction. Elbow ligament reconstruction is reserved for complete tears or ruptures in which ligaments are completely detached from the bone. Injuries of this nature are usually caused by high-energy traumas such as falls or injuries caused by accidents. 

Symptoms that one has sustained a ligament tear include:

• An audible  “pop” during the time of injury
• Weakness of grip
• Unintended clumsiness
• Loss of function in the arm
• Reduced or inability to flex and bend the arm
• Pain followed by numbness and tingling
• Swelling
• Discolouration and bruising
• Worsening elbow instability 

Following your orthopaedic evaluation, imaging tests such as x-rays and magnetic resonance imaging (MRI) will be conducted to confirm surgery suitability. A surgery date will then be assigned. Depending on the type of surgery, the procedure would involve different techniques. Prior to addressing the injury, tendons are harvested from the forearm or the knee. One may also opt for donor-harvested tendons. Upon preparation of these tendons, surgery will be performed. 

Firstly, incisions are made over the elbow. Muscles, tendons, and nerves will be carefully moved to obtain a better view of the injury. Damaged ligaments are removed and your orthopaedic surgeon will assess other injuries in the area. If any are identified, these would be addressed in the surgery as well. 

To conduct the ligament reconstruction, holes are first drilled into the bones. Next, the harvested tendons are attached to the bones using special sutures. Upon completion of this process, the site is cleaned thoroughly before stitching the incisions up. 

• Reduces pain 
• Overcomes stiffness of the joint 
• Increased mobility 
• Effective 
• Improved quality of life

Elbow ligament reconstruction can be used to treat the following conditions:

• Ulnar collateral ligament tears: found in the inner part of the elbow, attaches the humerus and the ulna 
• Annular ligament tears: found at the head of the radius bone.  
• Radial collateral ligament tears: found at the outer elbow,  connecting the radius and the humerus.
• Medial collateral ligament tears: found in the inside of the elbow and connects the ulna to the humerus.
• Lateral collateral ligament: located on the outside of the elbow connecting the radius to the humerus.

Depending on the specific ligament reconstructed, the success rate varies, however, an average success rate of 85% has been noted in reconstruction surgeries. One can expect alleviation from pain and dysfunction of the arm post-recovery. 

Typically it would take between 2-6 weeks for pain symptoms to subside and resume daily activities. Within 3-6 months, one will regain their range of motion. You would, however, still need to continue physiotherapy for complete recovery of arm function which could take up to a year.

Discipline and dedication towards physiotherapy would help in speeding up recovery. Diets and post-surgical habits could also impact your healing rate. With positive post-surgical care and collaborative work with your orthopaedist, a positive outcome can be anticipated. 

Your orthopaedist can give you a better idea of what to expect based on your individual needs and circumstances.

Elbow ligament reconstruction is a one-off treatment. It is important that post-operative care is practised to avoid further injury. It is very unlikely that one undergoes an elbow ligament reconstruction the second time. Secondary surgeries occur when a revision of the first surgery is required or if subsequent injuries are sustained. 

In the event bones at the elbow begin deteriorating along with ligaments, a different treatment approach such as an elbow replacement surgery (link to service page)  would be explored. However, this is only in situations where patients have underlying health conditions such as arthritis or sustain a high-impact injury that fractures the bones in fragments. 

Habits such as smoking will also impede the recovery rate. To attain complete recovery, one will need to attend physiotherapy sessions and appropriately manage medications such as painkillers, antibiotics, and blood thinners. The frequency of physiotherapy sessions will vary according to your condition. 

Your orthopaedist will be able to provide you with a bespoke treatment plan, tailored to your needs and requirements.