Arthroscopic Plication of the Radial Component of the Lateral Collateral Ligament (R-LCL)

  • Paolo Angelo Arrigoni
  • Riccardo D’Ambrosi
  • Davide Cucchi
  • Pietro Simone Randelli


This chapter presents the technique and the results of arthroscopic plication of the radial component of the lateral collateral ligament (R-LCL). Elongation or partial articular-sided tears of the R-LCL may lead to a symptomatic minor instability of the lateral elbow (SMILE) and cause lateral elbow pain and disability. An all-arthroscopic technique to repair the R-LCL with a suture anchor was developed. The benefits of this all-arthroscopic procedure for surgical stabilization of the R-LCL include smaller incisions with less soft-tissue dissection, better visualization of the joint, easier accessibility for surgical instruments, and possibility of effective control lateral elbow patholaxity. The main steps of the operation are test of lateral elbow patholaxity, evaluation of the annular drive-through (ADT) sign, inspection of the radial side of the joint, insertion of a suture anchor through the anterolateral portal, shuttling of the suture anchor through the ligament, and verification of effective elimination of the annular drive-through sign. This technique of R-LCL plication ensures an anatomic repair.

We analyzed the presence of intra-articular pathologic findings in 35 patients, and we treated with R-LCL plication 27 patients, which were subsequently evaluated at a median follow-up of 2.1 years. In this group, mean single assessment numeric evaluation (SANE) improved from median of 30 points preoperatively to 90 at final follow-up, and 96.3% patients obtained good or excellent subjective results. No major complications were observed.


Epicondylitis Radial component of the lateral collateral ligament Patholaxity Plication Minor instability 



Conflict of Interest: None


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Copyright information

© ISAKOS 2020

Authors and Affiliations

  • Paolo Angelo Arrigoni
    • 1
    • 2
  • Riccardo D’Ambrosi
    • 3
  • Davide Cucchi
    • 1
    • 4
  • Pietro Simone Randelli
    • 1
    • 2
  1. 1.Laboratory of Applied Biomechanics, Department of Biomedical Sciences for HealthUniversità degli Studi di MilanoMilanItaly
  2. 2.Clinica Ortopedica, CTOASST Centro Specialistico Ortopedico Traumatologico Gaetano Pini-CTOMilanItaly
  3. 3.Unità Operativa C.A.S.C.O. IRCCS Istituto Ortopedico GaleazziMilanItaly
  4. 4.Department of Orthopaedics and Trauma SurgeryUniversitätsklinikum BonnBonnGermany

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