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Ivan H. Wong, M. D. , M. Sc. , F. R. C. S. C. , Dip

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Presentation on theme: "Ivan H. Wong, M. D. , M. Sc. , F. R. C. S. C. , Dip"— Presentation transcript:

1 Arthroscopic Anatomic Glenoid Reconstruction Without Subscapularis Split 
Ivan H. Wong, M.D., M.Sc., F.R.C.S.C., Dip. Sports Medicine, Nathan Urquhart, M.D., M.Sc., F.R.C.S.C., Dip. Sports Medicine  Arthroscopy Techniques  Volume 4, Issue 5, Pages e449-e456 (October 2015) DOI: /j.eats Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

2 Fig 1 Semi-lateral position with pneumatic arm holder.
Arthroscopy Techniques 2015 4, e449-e456DOI: ( /j.eats ) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

3 Fig 2 Frozen distal tibia allograft is used as the donor graft.
Arthroscopy Techniques 2015 4, e449-e456DOI: ( /j.eats ) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

4 Fig 3 Micro sagital saw is used to prepare the graft segment. The posterolateral corner tends to have the best contour. Arthroscopy Techniques 2015 4, e449-e456DOI: ( /j.eats ) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

5 Fig 4 DePuy Mitek Bristow-Latarjet Instability Shoulder System guide is used to place two guide wires, which are then overdrilled with the cannulated drill. Arthroscopy Techniques 2015 4, e449-e456DOI: ( /j.eats ) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

6 Fig 5 The grafts are then tapped and top-hat washers placed to dissipate hoop stresses when later tightened. Arthroscopy Techniques 2015 4, e449-e456DOI: ( /j.eats ) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

7 Fig 6 The double barrel cannula system is then attached to the graft via the top-hat washers. Arthroscopy Techniques 2015 4, e449-e456DOI: ( /j.eats ) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

8 Fig 7 A switching stick placed in the posterior portal is used to shift the subscapularis inferiorly allowing the graft to be placed without splitting the subscapularis muscle. Arthroscopy Techniques 2015 4, e449-e456DOI: ( /j.eats ) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

9 Fig 8 Guide wires are placed to temporarily affix the graft in proper position on the glenoid before drilling and placing the cannulated screws. Arthroscopy Techniques 2015 4, e449-e456DOI: ( /j.eats ) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

10 Fig 9 Allograft in position viewed from the (A) anteriosuperior and (B) posterior portals. Arthroscopy Techniques 2015 4, e449-e456DOI: ( /j.eats ) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

11 Fig 10 Bankart style capsule/labral reattachment.
Arthroscopy Techniques 2015 4, e449-e456DOI: ( /j.eats ) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

12 Fig 11 Postoperative incisions.
Arthroscopy Techniques 2015 4, e449-e456DOI: ( /j.eats ) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

13 Fig 12 Postoperative computed tomography scan.
Arthroscopy Techniques 2015 4, e449-e456DOI: ( /j.eats ) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions


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