Elbow Ulnar Collateral Ligament Reconstruction Using a 4-Strand Docking Plus Technique.

The "Docking Plus" technique for elbow ulnar collateral ligament (UCL) surgery is described in the following text and video. Depite the general success of UCL surgery, significant rates of retear and failure of return to competition persist. Hypothesized reasons for UCL surgery failure include insufficient graft strength (midsubstance tears), insufficient graft tensioning (functional UCL insufficiency, valgus extension overload), and insufficient healing of graft to bone (proximal avulsions). This technique is meant to incorporate the best aspects of the previously described techniques for UCL reconstruction to create a larger, stronger, better-tensioned graft with a larger healing surface area to bone, a lower retear rate, and a lower risk of complications. The Docking Plus technique has been used since 2012.