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Arthroscopic Capsulolabral Revision Repair for Recurrent Anterior Shoulder Instability by Christoph Bartl, and Andreas B. Imhoff JBJS Essent Surg Tech.

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Presentation on theme: "Arthroscopic Capsulolabral Revision Repair for Recurrent Anterior Shoulder Instability by Christoph Bartl, and Andreas B. Imhoff JBJS Essent Surg Tech."— Presentation transcript:

1 Arthroscopic Capsulolabral Revision Repair for Recurrent Anterior Shoulder Instability by Christoph Bartl, and Andreas B. Imhoff JBJS Essent Surg Tech Volume 2(1):e2 January 11, 2012 ©2012 by The Journal of Bone and Joint Surgery, Inc.

2 Christoph Bartl, and Andreas B. Imhoff JBJS Essent Surg Tech 2012;2:e2 ©2012 by The Journal of Bone and Joint Surgery, Inc.

3 Christoph Bartl, and Andreas B. Imhoff JBJS Essent Surg Tech 2012;2:e2 ©2012 by The Journal of Bone and Joint Surgery, Inc.

4 Christoph Bartl, and Andreas B. Imhoff JBJS Essent Surg Tech 2012;2:e2 ©2012 by The Journal of Bone and Joint Surgery, Inc.

5 Christoph Bartl, and Andreas B. Imhoff JBJS Essent Surg Tech 2012;2:e2 ©2012 by The Journal of Bone and Joint Surgery, Inc.

6 Christoph Bartl, and Andreas B. Imhoff JBJS Essent Surg Tech 2012;2:e2 ©2012 by The Journal of Bone and Joint Surgery, Inc.

7 Christoph Bartl, and Andreas B. Imhoff JBJS Essent Surg Tech 2012;2:e2 ©2012 by The Journal of Bone and Joint Surgery, Inc.

8 Christoph Bartl, and Andreas B. Imhoff JBJS Essent Surg Tech 2012;2:e2 ©2012 by The Journal of Bone and Joint Surgery, Inc.

9 Christoph Bartl, and Andreas B. Imhoff JBJS Essent Surg Tech 2012;2:e2 ©2012 by The Journal of Bone and Joint Surgery, Inc.

10 Christoph Bartl, and Andreas B. Imhoff JBJS Essent Surg Tech 2012;2:e2 ©2012 by The Journal of Bone and Joint Surgery, Inc.

11 Christoph Bartl, and Andreas B. Imhoff JBJS Essent Surg Tech 2012;2:e2 ©2012 by The Journal of Bone and Joint Surgery, Inc.

12 Christoph Bartl, and Andreas B. Imhoff JBJS Essent Surg Tech 2012;2:e2 ©2012 by The Journal of Bone and Joint Surgery, Inc.

13 Christoph Bartl, and Andreas B. Imhoff JBJS Essent Surg Tech 2012;2:e2 ©2012 by The Journal of Bone and Joint Surgery, Inc.

14 Christoph Bartl, and Andreas B. Imhoff JBJS Essent Surg Tech 2012;2:e2 ©2012 by The Journal of Bone and Joint Surgery, Inc.

15 Computed tomography sagittal view showing minimal anteroinferior glenoid bone loss with a small fragment (circled) before the revision repair. Christoph Bartl, and Andreas B. Imhoff JBJS Essent Surg Tech 2012;2:e2 ©2012 by The Journal of Bone and Joint Surgery, Inc.

16 Axial magnetic resonance image showing an anterior labroligamentous periosteal sleeve avulsion (ALPSA) lesion (arrow) with medial retraction of the labroligamentous complex. Christoph Bartl, and Andreas B. Imhoff JBJS Essent Surg Tech 2012;2:e2 ©2012 by The Journal of Bone and Joint Surgery, Inc.

17 Inspection of the retracted labrum (arrowheads) with a probe through the posterior portal. Christoph Bartl, and Andreas B. Imhoff JBJS Essent Surg Tech 2012;2:e2 ©2012 by The Journal of Bone and Joint Surgery, Inc.

18 The retraction of the labroligamentous complex (arrowheads) with scarring to the glenoid neck is best seen through the anterosuperior portal. Christoph Bartl, and Andreas B. Imhoff JBJS Essent Surg Tech 2012;2:e2 ©2012 by The Journal of Bone and Joint Surgery, Inc.

19 The anteroinferior 5:30 portal is placed through the lower part of the subscapularis muscle. Christoph Bartl, and Andreas B. Imhoff JBJS Essent Surg Tech 2012;2:e2 ©2012 by The Journal of Bone and Joint Surgery, Inc.

20 The incision is just lateral to the axillary fold, about 8 to 10 cm distal to the coracoid process. Christoph Bartl, and Andreas B. Imhoff JBJS Essent Surg Tech 2012;2:e2 ©2012 by The Journal of Bone and Joint Surgery, Inc.

21 Mobilization of the capsulolabral complex with a rasp, to create a healing bone bed. Christoph Bartl, and Andreas B. Imhoff JBJS Essent Surg Tech 2012;2:e2 ©2012 by The Journal of Bone and Joint Surgery, Inc.

22 Preparation of the anchor insertion site on the glenoid rim (arrow). Christoph Bartl, and Andreas B. Imhoff JBJS Essent Surg Tech 2012;2:e2 ©2012 by The Journal of Bone and Joint Surgery, Inc.

23 Christoph Bartl, and Andreas B. Imhoff JBJS Essent Surg Tech 2012;2:e2 ©2012 by The Journal of Bone and Joint Surgery, Inc.

24 Christoph Bartl, and Andreas B. Imhoff JBJS Essent Surg Tech 2012;2:e2 ©2012 by The Journal of Bone and Joint Surgery, Inc.

25 Christoph Bartl, and Andreas B. Imhoff JBJS Essent Surg Tech 2012;2:e2 ©2012 by The Journal of Bone and Joint Surgery, Inc.

26 Christoph Bartl, and Andreas B. Imhoff JBJS Essent Surg Tech 2012;2:e2 ©2012 by The Journal of Bone and Joint Surgery, Inc.

27 Note the creation of the anterior neolabrum (bumper) after knot tying. Christoph Bartl, and Andreas B. Imhoff JBJS Essent Surg Tech 2012;2:e2 ©2012 by The Journal of Bone and Joint Surgery, Inc.

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