AANA Shoulder Arthroscopy - August 2024-Anterior Instability Repair_ Portals, Anchors, and Suture Passage- Maximizing Your Repair

Anterior Instability Repair_ Portals, Anchors, and Suture Passage- Maximizing Your Repair

Video Transcription

Video Summary

This presentation discusses advanced arthroscopic techniques for shoulder instability repair focusing on labral and capsular restoration. Key principles include proper portal placement for visualization and working access, utilizing horizontal mattress sutures to maximize labral height and stability, and performing adequate capsular shifts. The remplissage procedure, which involves infraspinatus tenodesis to address Hill-Sachs lesions by preventing engagement and shifting the humeral head posteriorly, is emphasized as an effective alternative to more invasive bony procedures like Latarjet. Anchor placement on the articular surface is critical to restore the "bumper" effect, and bone grafting under the labrum may enhance glenoid bone stock. Clinical evidence shows remplissage yields low recurrence and complication rates compared to Latarjet. Overall, the speaker advocates for arthroscopic restoration of native anatomy, combining remplissage with capsular shift and labral repair to optimize stability while minimizing morbidity.

Asset Caption

John Kelly, MD

Keywords

arthroscopic shoulder instability repair

labral restoration

capsular shift

remplissage procedure

Hill-Sachs lesion management

Latarjet alternative