Abstract
In the treatment of anterior shoulder instability with glenoid bone loss, free bone graft transfers have proven to be a viable anatomic alternative to the commonly performed, nonanatomic Latarjet procedure. Implant-free fixation of the free bone grafts, in particular, has rendered excellent short- and long-term results. However, a drawback remains the source of the graft. We describe an arthroscopic bone block cerclage technique using a tricortical scapular spine autograft, which provides an anatomic arthroscopic glenoid reconstruction with the combined benefit of sparing the subscapularis, metal-free fixation, and intraregional donor site for autograft harvesting.
Highlights
The extent of glenoid bone loss is one of the most important risk factors leading to recurrent shoulder instability after soft-tissue stabilization procedures.[1]
All patients with multiple episodes of anterior shoulder instability should be evaluated with 3-dimensional computed tomography (CT) to assess humeral and glenoid bone loss
In situ measurement of the anterior glenoid defect is crucial to achieve a perfect fit of the autograft
Summary
The surgical technique is demonstrated in the Video 1. Preoperative Assessment and Indications An elaborate patient history is obtained, and a functional assessment is performed with complete clinical examination to determine the type of instability, functional demand, joint laxity, and possible other pathologies, followed by a detailed radiologic assessment. All patients with multiple episodes of anterior shoulder instability should be evaluated with 3-dimensional computed tomography (CT) to assess humeral and glenoid bone loss. The current technique is indicated in patients with symptomatic anterior shoulder instability and concomitant measured glenoid bone loss >15%. Patient Positioning and Diagnostic Arthroscopy Under general anesthesia and with a routine singleshot antibiotic regimen, the patient is placed in the
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