Ulnar collateral ligament reconstruction techniques in elbow instability: Jobe versus Docking technique. A systematic review

INTRODUCTION: Ulnar collateral ligament (UCL) tears are common in overhead throwing athletes and contact sport ones. The Jobe and docking techniques are the most common techniques used for reconstruction. This systematic review aims to assess the clinical outcome and the complication rates of the surgical techniques currently used. EVIDENCE ACQUISITION: PubMed, MEDLINE and Cochrane were searched from January 2010 to April 2021 to identify relevant studies. The search terms used were "UCL," "medial instability of the elbow," "elbow Docking technique," and "elbow Jobe technique." The methodological qualities of the studies were evaluated, relevant data were extracted. EVIDENCE SYNTHESIS: Five studies, published between 2013 and 2019, were included in this review. Three studies had a level of evidence IV, two studies had a level of evidence III and recruited 600 patients undergoing a Docking and 30 patients undergoing a Jobe technique reconstruction. Patients undergoing Docking procedure registered better clinical and functional outcome, assessed using the Conway Jobe scale compared with patients managed with Jobe technique. Nonetheless, this difference is not significant. Complication rate was 7.5%, mainly affecting the ulnar nerve (95.5%). CONCLUSIONS: This systematic review demonstrated that both Jobe and Docking techniques are effective and safe in the treatment of UCL rupture. However, future studies with larger sample size of Jobe technique are needed to show statistical differences between these two surgical approaches.