Arthroscopic Removal of Symptomatic Proximal Humerus Locking Plates With Bone- Void Filler Augmentation  Pramod B. Voleti, M.D., Christopher L. Camp, M.D., Alec L. Sinatro, B.A., Joshua S. Dines, M.D.  Arthroscopy Techniques  Volume 5, Issue 2, Pages e343-e346 (April 2016) DOI: 10.1016/j.eats.2016.01.009 Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 1 With the patient in the beach chair position, key anatomical landmarks are identified and drawn. Care should be taken to identify the transverse path of the axillary nerve approximately 5 to 7 cm from the lateral border of the acromion. The camera is placed in the standard posterior portal, and a diagnostic arthroscopy is performed. Arthroscopy Techniques 2016 5, e343-e346DOI: (10.1016/j.eats.2016.01.009) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 2 (A) When viewing from a posterior portal, a radiofrequency device is used to expose the proximal portion of the locking plate. Here a suture that was used for rotator cuff repair is easily identified. (B) Dissection is carried out along the length of the plate using the radiofrequency device until the plate and all screws are fully visualized. (C) Care is taken to identify, protect, and preserve the axillary nerve and posterior circumflex humeral artery along the undersurface of the deltoid. Arthroscopy Techniques 2016 5, e343-e346DOI: (10.1016/j.eats.2016.01.009) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 3 (A) When viewing the distal part of the plate from the posterior portal, the distal-most screws are removed arthroscopically through a PassPort cannula (Arthrex) so that they are not lost in the soft tissues. (B) Once all screws are removed, the bone-void filler (QuickSet Injectable Macroporous Calcium Phosphate; Arthrex) is arthroscopically injected through the PassPort cannula. (C) The proximal screws may be easier to inject in an open fashion through the same small incision that will be used to remove the plate. The plate is left in place during injection of the bone-void filler as this facilitates identifying all screw holes. Once all holes have been filled, the plate is removed. Arthroscopy Techniques 2016 5, e343-e346DOI: (10.1016/j.eats.2016.01.009) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions