Lateral Ulnar Collateral Ligament Reconstruction
The lateral ulnar collateral ligament is the primary stabilizer on the outer side of the elbow joint, preventing the forearm bones from shifting away from the humerus during everyday movements and athletic activity. When a severe elbow dislocation, traumatic fall, or high-impact sports injury stretches or tears this ligament beyond its ability to heal, the result is a condition called posterolateral rotatory instability — a persistent looseness in the joint that allows the elbow to partially sublux or give way when force is applied, particularly during pushing, lifting, or weight-bearing through the arm. In some cases, this instability also develops gradually following prior elbow surgery or repeated minor injuries. When the lateral ulnar collateral ligament cannot be adequately restored through rehabilitation alone, surgical reconstruction is the most reliable way to regain lasting joint stability and full functional use of the arm.
Dr. Jonathan Glashow is a board-certified orthopedic surgeon and Clinical Associate Professor of Orthopedic Surgery at NYU Grossman School of Medicine, with over 30 years of experience performing complex ligament reconstruction procedures. Fellowship-trained in sports medicine and arthroscopic surgery at the Southern California Orthopedic Institute/UCLA — and through a traveling shoulder fellowship under Charles Rockwood, MD and Richard Hawkins, MD — he brings an elite level of ligament surgery expertise to every case. As Chief Medical Officer for the New Jersey Devils and Philadelphia 76ers, Dr. Glashow manages high-stakes elbow instability injuries in professional athletes who cannot afford compromised joint function. He has performed more than 15,000 orthopedic procedures, has been named a Castle Connolly Top Doctor every year since 2000, and offers lateral ulnar collateral ligament reconstruction at his Upper East Side practice in New York City.
Advanced Surgical Elbow Ligament Repair
Dr. Glashow is among the top sports medicine and orthopedic surgeons in the country. He has performed complex orthopedic surgeries on top athletes to help them regain complete function to resume their physical abilities. Our medical facility offers lateral ulnar collateral ligament reconstruction that can repair the main stabilizing ligament in the elbow and restore proper function. We offer same day appointments for urgent injuries and concierge service for excellent medical care for all of our patients.
If you suffer a severe elbow dislocation or lateral ulnar collateral ligament damage, Dr. Jonathan Glashow offers the expertise you need for treatment or surgery. Contact our facility in the Upper East Side to schedule an evaluation.
Frequently Asked Questions About Lateral Ulnar Collateral Ligament Reconstruction
What is the lateral ulnar collateral ligament, and what does it do?
The lateral ulnar collateral ligament — often abbreviated as the LUCL — is a band of strong tissue on the outer side of the elbow that connects the humerus to the ulna. Its primary role is to prevent the forearm from rotating outward and away from the upper arm during movement. When the LUCL is intact, the elbow remains stable during pushing, lifting, and weight-bearing activities. When it is torn or stretched beyond its capacity to heal, the elbow becomes susceptible to episodes of giving way, clicking, or partial dislocation — a condition known as posterolateral rotatory instability.
What causes lateral ulnar collateral ligament damage?
The most common cause is a severe elbow dislocation, which stretches or tears the LUCL as the bones are forced out of alignment. The ligament can also be damaged during a fall onto an outstretched hand, from repetitive high-force loading in contact sports or overhead athletics, or as a complication of prior elbow surgery — particularly procedures performed on the lateral side of the joint. In some patients, chronic instability develops gradually as the ligament weakens over time from repeated low-grade injuries that never fully heal.
How is LUCL insufficiency diagnosed?
Dr. Glashow begins with a detailed clinical examination, including specific provocative tests — such as the lateral pivot shift test and the posterolateral rotatory drawer test — that reproduce the characteristic instability pattern. He also assesses grip strength, range of motion, and nerve function throughout the arm. Advanced imaging, including X-rays and MRI, helps confirm the extent of ligament damage, rule out associated fractures or cartilage injury, and guide surgical planning.
What does the reconstruction surgery involve?
During lateral ulnar collateral ligament reconstruction, Dr. Glashow replaces the damaged ligament with a tendon graft — typically harvested from the patient’s own forearm (palmaris longus) or from a donor source. The graft is threaded through precisely drilled tunnels in the humerus and ulna and secured with fixation devices to recreate the anatomical path and tension of the original ligament. The procedure is performed through a small incision on the outer side of the elbow and is designed to restore full rotational stability to the joint.
What does recovery look like after LUCL reconstruction?
Patients typically wear a hinged brace for the first several weeks after surgery to protect the graft while allowing controlled, progressive motion. A structured physical therapy program begins shortly after the procedure, focusing initially on range-of-motion recovery and gradually progressing to strengthening exercises over the following months. Most patients return to daily activities within six to eight weeks and to full sports or physically demanding work within four to six months, depending on the demands of the activity. Dr. Glashow coordinates rehabilitation closely with physical therapists and athletic trainers to ensure the reconstructed ligament heals with optimal stability and function.
Can the LUCL be repaired instead of reconstructed?
In acute cases — where the ligament tear is recent and the tissue quality is still good — Dr. Glashow may be able to repair the LUCL directly, sometimes augmenting the repair with an internal brace for additional stability during healing. However, when the ligament is chronically stretched, severely torn, or the tissue has degenerated to the point where a direct repair would not provide reliable long-term stability, full reconstruction with a tendon graft is the preferred approach. Dr. Glashow determines the best option based on the timing of the injury, the condition of the remaining ligament tissue, and the patient’s functional demands.
