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Arthroscopic Glenoid Reconstruction (Bony Bankart)

February 01, 2014

Contributors: David Suprenant, Medical Student; Gregory J. Barton, Medical Student; Brittany Kaim, Medical Student; Steven C. Chudik, MD; Steven C. Chudik, MD

Arthroscopic glenoid reconstruction, or bony Bankart reconstruction, is a minimally invasive surgical procedure developed to reconstruct a glenoid that has been damaged from previous shoulder dislocations. Glenoid reconstruction restores stability and prevents further damage to the glenoid surface caused by recurrent dislocations. Patients with bony Bankart lesions involving more than 20% to 25% bone loss require glenoid reconstruction as well as soft-tissue repair of the capsular labral tissue. Glenoid reconstruction previously was limited to open bone augmentation procedures because of the technical limitations of arthroscopic shoulder joint access provided by arthroscopic portals. Using a novel low anterior portal and special guide, perpendicular access to the fracture plane is improved, and glenoid reconstruction, as well as soft-tissue repair of the capsular labral tissue, can be performed with this minimally invasive arthroscopic technique. No neuropraxias or vascular injuries have been reported with only sharp incision of the skin followed by blunt insertion of the cannula and instruments through the novel low anterior portal. In the small series of procedures that have been performed, all patients were slow to regain their external rotation because of medialization of the anterior capsular labral tissue to the native glenoid over the bone graft. However, with time, all have regained this motion to full or near-full external rotation and have demonstrated functional results without symptoms or recurrent instability.

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