APEX Optimizing Surgical Outcomes for Knee & Shoulder Arthroscopy-Track 2: Optimizing Bone Deficiency: Arthroscopic vs. Open Latarjet, Posterior Approach to Shoulder

Track 2: Optimizing Bone Deficiency: Arthroscopic vs. Open Latarjet, Posterior Approach to Shoulder

Video Transcription

Video Summary

Dr. John D. Kelly IV discusses surgical approaches to shoulder instability, focusing on optimizing treatment for bone deficiency through arthroscopic versus open Latarjet procedures. He emphasizes individualized treatment and the importance of preserving native anatomy, noting that open Latarjet carries risks like subscapularis damage and decreased rotation. Arthroscopic techniques can address labral repair, capsule shifting, and bone grafting effectively. Kelly highlights the significance of Hill-Sachs lesions and advocates for remplissage to reduce recurrence regardless of lesion type. Critical glenoid bone loss is variable but generally problematic above 10-13%, necessitating bone grafting using autograft or allograft, with his innovative autobridge technique showing promise in graft integration. He also covers posterior shoulder instability, linked to retroversion and bone loss, treatable arthroscopically with labral repair, capsular shift, and posterior bone grafting. Kelly concludes that most instability cases can be managed arthroscopically, with large bone losses requiring open or graft procedures, emphasizing careful surgical planning and technique to minimize complications and improve outcomes.

Asset Caption

Faculty: John D. Kelly, IV, M.D., FAANA

Keywords

shoulder instability

arthroscopic Latarjet

open Latarjet

bone deficiency treatment

Hill-Sachs lesions

posterior shoulder instability