Arthroscopic Glenoid Reconstruction Surgical Technique

Arthroscopic Glenoid Reconstruction

Arthroscopic Glenoid Reconstruction

1
The arm and the ipsilateral iliac crest are draped accordingly and the arm is positioned in the 3-Point Shoulder distraction System using a STaR-Sleeve and 5 kg horizontal as well as 3 kg vertical load, while the arm is 20 external rotated. Harvesting of a tricortical Bone block from the iliac crest. The size is generally 2.5-3 1-1.5 1-1.5 cm, according to the loss of Glenoidal substance.

2
The following Portals should be established: posterior, anterosuperior or suprabicipital respectively, anteroinferior and a deep anteroinferior Portal.

3
Prepare the Glenoid rim and the Scapula neck, using an oval burr, to assure alignment and bone block healing.

4
For the transport of the graft into the joint, the Cannula through the Rotator interval has to be temporally removed. The skin incision has to be enlarged about 1 cm. The graft is positioned in a strong straight clamp and gently pushed through the portal, until it is positioned in between the Scapula neck and the subscapular muscle.

5
Final positioning of the graft, using a switching stick through the posterior postal and the Glenoid RepairGuide through the deep anteroinferior Portal. The Glenoid Repair-Guide is pressed against the caudal part of the graft, the integrated Guidewire sheath has to face cranial. A 1.1 mm K-Wire is positioned in the Guidewire sheath and drilled through the graft and the scapula neck into the dorsal cortex.

6
The free Bio-Compression Drill is pushed into the guide and a second 1.1 mm K-Wire is drilled through the canulation of the drill, until it reaches the posterior cortex. Now, the graft is temporarily fixed and rotation stable.

7
The caudal K-Wire can now be over-drilled, using the BioCompression Drill, until the proximal Lasermark is flush with the end of the Glenoid Repair-Guide.

8
The Drill is removed and the Bio-Compression Tap is manually used to pretap the hole. The Lasermark on the Tap also has to be flush with the guide.

Surgical Technique

9
Remove the K-Wire and the Tap and the first 3 mm BioCompression Screw (AR-5025B-26) for the final fixation of the graft can be screwed in, until it is countersunk about 1-2 mm underneath the cortex.

10
The Glenoid Repair-Guide can now be twisted 180 around the remaining K-Wire.

11
Repeat Step 6 to 10 at the cranial part of the graft and position the second screw. The use of the K-Wire is optional.

12
After the application of the second screw, an oval burr can be used to smoothen the surface of the graft and to level it at Glenoid hight if needed. Soft Tissue fixation starts with the anteroinferior part of the Labrum, using a 2.9 mm PushLock, two additional 2.9 mm PushLock Anchors are used for the anterosuperior Labrum.

Ordering Information
Implants & Disposables: Bio-Compression Screw, 3.0 x 26 mm AR-5025B-26 K-Wire 1.1 mm KW02-300-11 Required Instruments: Glenoid Repair Guide AR-5024 Long Drill for 26 mm BC-Screw AR-5025ETDC-26 Long Tap for 26 mm BC-Screw AR-5025ETBC-26 Long Driver for 26 mm BC-Screw AR-5025EDB Handle AO-Connect AR-2001AOT 2.9 mm PushLock Implants: Bio-PushLock, 2.9 mm x 10.7 mm BioComposite PushLock, 2.9 mm x 10.7 mm PEEK PushLock, 2.9 mm x 10.7 mm

AR-1923B AR-1923BC AR-1923PS

Required Instruments: Spear, Trocar and Blunt Tip Obturator, for 2.9 mm PushLock AR-1949 Drill, for 2.9 mm PushLock AR-1923DL Cannulas Twist-In Cannula, 8.25 mm x 7.0 cm Twist-In Cannula, 6.0 mm x 7.0 cm Twist-In Cannula, 8.25 mm x 9.0 cm

AR-6530 AR-6535 AR-6540

Recommended FiberWire #2 FiberWire, 38 inches (blue) AR-7233 #2 TigerWire, 38 inches (white) AR-7203 FiberStick and TigerStick FiberStick, #2 FiberWire, 50 inches (blue) one end stiffened, 12 inches TigerStick, #2 TigerWire, 50 inches (white/black) one end stiffened, 12 inches FiberLinkTM FiberLink, #2 FiberWire w/loop (blue) FiberLink, #2 FiberWire w/loop (white/black) AR-7209 AR-7209T AR-7235 AR-7235T

SutureLasso SD SutureLasso SD, 90 up AR-4068-90 SutureLasso SD, crescent AR-4068C SutureLasso SD, 45 curve right AR-4068-45R SutureLasso SD, 45 curve left AR-4068-45L SutureLasso SD, 25 tight curve right AR-4068-25R SutureLasso SD, 25 tight curve left AR-4068-25L SutureLasso SD, 90 curve right AR-4068-90R SutureLasso SD, 90 curve left AR-4068-90L SutureLasso SD, 30 straight AR-4068-30

Developed in Collaboration with Priv.-Doz. Dr. M. Scheibel, Berlin

This description of technique is provided as an educational tool and clinical aid to assist properly licensed medical professionals in the usage of specific Arthrex products. As part of this professional usage, the medical professional must use their professional judgment in making any final determinations in product usage and technique. In doing so, the medical professional should rely on their own training and experience and should conduct a thorough review of pertinent medical literature and the products Directions For Use.

Copyright Arthrex Medizinische Instrumente GmbH, 2012. All rights reserved. U.S. PATENT NOS. 5,964,783; 6,652,563;6,716,234;7,029,490 and PATENT PENDING LT2-0517-EN_B