Arthroscopic Glenoid Reconstruction

8/12/2019 Arthroscopic Glenoid Reconstruction

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Arthroscopic Glenoid Reconstruction

Surgical Technique


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The arm and the ipsi lateral 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.

The following Portals should be established: posterior,

anterosuperior or suprabicipital respectively, anteroinferior

and a deep anteroinferior Portal.

Prepare the Glenoid rim and the Scapula neck, using an

oval burr, to assure alignment and bone block healing.

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 pushedthrough the portal, until it is positioned in between the

Scapula neck and the subscapular muscle.

Arthroscopic Glenoid Reconstruction

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Final positioning of the graft, using a switching stick

through the posterior postal and the Glenoid Repair-

Guide 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.

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.

The caudal K-Wire can now be over-drilled, using the Bio-

Compression Drill, until the proximal Lasermark is flush

with the end of the Glenoid Repair-Guide.

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.

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Remove the K-Wire and the Tap and the first 3 mm Bio-

Compression 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.

The Glenoid Repair-Guide can now be twisted 180

around the remaining K-Wire.

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.

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.

Surgical Technique

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Ordering Information

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

2.9 mm PushLockImplants:Bio-PushLock, 2.9 mm x 10.7 mm AR-1923B

BioComposite PushLock, 2.9 mm x 10.7 mm AR-1923BCPEEK PushLock, 2.9 mm x 10.7 mm AR-1923PS

Required Instruments:Spear, Trocar and Blunt Tip Obturator, for 2.9 mm PushLock AR-1949Drill, for 2.9 mm PushLock AR-1923DL

CannulasTwist-In Cannula, 8.25 mm x 7.0 cm AR-6530Twist-In Cannula, 6.0 mm x 7.0 cm AR-6535Twist-In Cannula, 8.25 mm x 9.0 cm 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 AR-7209TigerStick, #2 TigerWire, 50 inches (white/black) one end stiffened, 12 inches AR-7209T

FiberLinkTM

FiberLink, #2 FiberWire w/loop (blue) AR-7235FiberLink, #2 FiberWire w/loop (white/black) AR-7235T

SutureLasso SDSutureLasso SD, 90 up AR-4068-90SutureLasso SD, crescent AR-4068CSutureLasso SD, 45 curve right AR-4068-45RSutureLasso SD, 45 curve left AR-4068-45LSutureLasso SD, 25 tight curve right AR-4068-25RSutureLasso SD, 25 tight curve left AR-4068-25LSutureLasso SD, 90 curve right AR-4068-90R

SutureLasso SD, 90 curve left AR-4068-90LSutureLasso SD, 30 straight AR-4068-30


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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

Arthroscopic Glenoid Reconstruction

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