Arthroscopic Glenoid Reconstruction, Bone Blocks and Transfers in the Management of Complex Shoulder Instability With Bone Loss: Advanced Concepts and Surgical Techniques: Interactive and Case -Based (AANA22)-Glenoid Reconstruction for Complex Bone Loss Q&A

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Video Summary

The discussion centers on surgical treatments for shoulder instability focusing on bone graft techniques such as distal tibial allograft (DTA) and Latarjet procedures. Rachel highlights that while the "sling effect" of the Latarjet is real, other bone block options like DTA offer comparable stability outcomes. The speakers emphasize the importance of accurately assessing bone loss—typically over 10%—to decide when to perform bone augmentation rather than soft tissue repair alone. Bone graft sizing is critical to avoid resorption, with experts suggesting grafts be tailored closely to the patient's anatomy to promote healing and reduce complications like hardware issues. The arthroscopic approach to graft placement is preferred for its anatomical precision and easier revisions. There is debate around capsular repair technique, with concerns that improper closure may cause stiffness or failure. Overall, graft choice, surgical technique, fixation method, and capsular management must be optimized to improve stability and reduce recurrence and complications.

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Richard K.N. Ryu, M.D.

Keywords

shoulder instability

bone graft techniques

distal tibial allograft

Latarjet procedure

capsular repair