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Thumb UCL InternalBrace™ Ligament Augmentation Procedure

  • The Injury: A thumb ulnar collateral ligament (UCL) tear is a common sports injury in football, baseball, hockey and basketball. The UCL ligament is located within the joint of the thumb and enables grasping and pinching. It needs to be repaired to restore stability and strength.
     
  • The Repair: Arthrex’s implant system is made of a high-strength flat suture, tensioned between two knotless anchors, either a DX SwiveLock® SL or Nano SwiveLock anchor. With the InternalBrace ligament augmentation procedure, a flat tape (SutureTape) is placed over the repair and acts like an “internal seat belt,” supporting and protecting the repaired ligament from further injury during the healing period. The “internal seat belt” metaphor is commonly used to describe the repair construct. There is no metal wire involved in the system.
     
  • Advantages of the InternalBrace Ligament Augmentation Procedure: Advantages include additional strength at the time of the surgery and throughout the healing period. Before InternalBrace ligament augmentation, surgeons would perform the repair and immobilize patients two or three times as long to allow the repair to heal and gain strength.1 See an animation of the thumb UCL InternalBrace ligament augmentation procedure.
     
  • Return to Play: Standard return to play without the InternalBrace augmentation procedure for a thumb UCL injury is between 8-12 weeks. With InternalBrace ligament augmentation repair, return to play has been between 5-6 weeks or even earlier depending on the patient’s pain and on the position he/she plays.1
     
  • History: The first InternalBrace technique was performed on an ankle sprain in 2013. The InternalBrace ligament augmentation procedure has been used in other parts of the body, including the hand, since 2015.
     
  • Patients: More than 75,000 thumb UCL InternalBrace augmentation procedures have been performed. It is available to all patients, not just high-level athletes. The thumb UCL InternalBrace ligament augmentation procedure has been performed on Drew Brees2 of the New Orleans Saints, Jonathan Taylor3 of the Indianapolis Colts, Mike Trout4 and Andrelton Simmons5 of the LA Angels, Chris Paul5 of the LA Clippers and others.

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References:

  1. Shin SS, van Eck CF, Uquillas C. Suture tape augmentation of the thumb ulnar collateral ligament repair: a biomechanical study. J Hand Surg. 2018;43(9): 868.e1–868.e6. doi:10.1016/j.jhsa.2018.02.002
  2. Shaw D, Shaw D. Saints quarterback plans for shorter recovery with Naples medical device. WINK News. https://winknews.com/2019/09/26/saints-quarterback-plans-for-shorter-recovery-with-naples-medical-device/. Published September 26, 2019.
  3. DeArdo B. Jonathan Taylor injury update: Surgeon used internal brace on UCL tear, Colts RB to miss 3-5 weeks, per report - CBSSports.com. CBSSports.com. Published November 28, 2023. https://www.cbssports.com/nfl/news/jonathan-taylor-injury-update-surgeon-used-internal-brace-on-ucl-tear-colts-rb-to-miss-3-5-weeks-per-report/
  4. Bell S. MLB - Inside Mike Trout’s thumb procedure, recovery process - ESPN. ESPN.com. https://www.espn.com/fantasy/baseball/story/_/id/19513187/mlb-mike-trout-thumb-procedure-recovery-process. Published June 5, 2017.
  5. Moura P. Mike Trout gets advice from Chris Paul and Andrelton Simmons on thumb injury - Los Angeles Times. Los Angeles Times. https://www.latimes.com/sports/angels/la-sp-angels-report-20170530-story.html. Published May 31, 2017.

The InternalBrace™ surgical technique is intended only to augment the primary repair/reconstruction by expanding the area of tissue approximation during the healing period and is not intended as a replacement for the native ligament. The InternalBrace technique is for soft tissue-to-bone fixation procedures and is not cleared for bone-to-bone fixation.