Arthroscopic Anatomic Glenoid Reconstruction in the Unstable Shoulder: Technique, Pearls, and Pitfalls.

BACKGROUND

Anterior shoulder instability with glenoid bone loss is a complex condition. Bankart repairs have higher failure rate in this population and the Latarjet procedure is associated with a high complication rate (15%-30%). A recent technique, the arthroscopic anatomic glenoid reconstruction, safely uses distal tibial allograft to augment the glenoid.

INDICATIONS

Glenoid or bipolar bone loss in the setting of shoulder instability.

TECHNIQUE DESCRIPTION

A diagnostic shoulder arthroscopy is performed to assess bone loss and capsulolabral tissue. After the preparation of the anterior glenoid, a bone block harvested from a distal tibial allograft is prepared. This technique uses the Halifax portal, a safe, far medial portal to insert the graft, and compress it onto the anterior glenoid using screws. A Bankart repair is then performed, to reduce the capsulolabral complex onto the glenoid.

RESULTS

Results at 2 years show a 92% to 100% union of the graft, no recurrence of instability, and improved patient-reported outcome scores. Graft remodeling is regularly observed on postoperative imaging. This procedure may be faster to learn and to perform compared to an arthroscopic Latarjet.

DISCUSSION/CONCLUSION: Arthroscopic anatomic glenoid reconstruction is a safe, minimally invasive procedure to address shoulder instability. It has low complication rate and is associated with improved patient-reported outcomes.

PATIENT CONSENT DISCLOSURE STATEMENT

The author(s) attest that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.