Minimally invasive treatment of valgus extension overload of the elbow

Abstract

Valgus extension overload (VEO) is a condition observed in overhead athletes that results from laxity of the ulnar collateral ligament (UCL). This laxity may cause bony abutment and impingement within the olecranon fossa, which in turn create posteromedial osteophytes. These osteophytes frequently lead to pain and dysfunction during the acceleration phase of throwing and release of the ball. This condition is one of many that frequently occur in the thrower’s elbow and often does not occur in isolation. Differential diagnosis can be complex, and treatment of VEO in isolation can exacerbate underlying UCL insufficiency. This condition can be treated with a variety of nonsurgical methods, including rest, ice, and physical therapy. If this treatment is unsuccessful, surgical intervention includes arthroscopic debridement of the symptomatic osteophyte, with the goal of restoring normal anatomy. Rehabilitation after surgery focuses on strength and range of motion and generally lasts between 12 and 16 weeks. After this time, many players are able to return to throwing at their previous level.