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Arthrosc Tech. 2015 Sep 21;4(5):e449-56. doi: 10.1016/j.eats.2015.04.005. eCollection 2015 Oct.

Arthroscopic Anatomic Glenoid Reconstruction Without Subscapularis Split.

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1
Dalhousie University and the Division of Orthopaedic Surgery, Capital District Health Authority, Halifax, Nova Scotia, Canada.

Abstract

The role of bone loss from the anterior glenoid in recurrent shoulder instability has been well established. We present a completely arthroscopic technique for reconstructing the anterior glenoid with distal tibial allograft and without a subscapularis split. We perform the arthroscopy in the lateral position. We measure and size an allograft distal tibial graft and place it arthroscopically. We use an inside-out medial portal to introduce the graft into the shoulder, passing it through the rotator interval and above the subscapularis. A double-cannula system is used to pass the graft, which is temporarily fixed with K-wires and held in place with cannulated screws. We then perform a Bankart-like repair of the soft tissues to balance the shoulder and augment our repair. Our technique is not only anatomic in the re-creation of the glenoid surface but also anatomic in the preservation of the coracoid and subscapularis tendon and repair of the capsulolabral complex.

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