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Chapter 11 Video 1: Osteochondral Allograft Humeral Head Reconstruction for Anterior Shoulder Instability

May 02, 2016

Contributors: Anthony Miniaci, MD,FRCSC

This video demonstrates osteochondral allograft humeral head reconstruction for anterior shoulder instability. The patient has had multiple previous surgeries, has limited external rotation because of over-tightening, and easily dislocates anteriorly. The humeral head is exposed and the defect measured; it is important to measure this in the x,y, and z planes. The lesion is squared off and abraded to bleeding bone, and the allograft is cut from the same location on the donor humeral head. The allograft is trialed and measured, and fine tuning cuts are made. This is temporarily fixed with K wires, then fixed in place with solid screws buried in the humeral head. The glenoid is evaluated, as humeral head and glenoid defects are commonly found concurrently. This may be repaired with the same allograft, the coracoid process, or a latarjet. Non-cannulated screws are used to minimize the chance of screw breakage in case of further injury or dislocation. The humeral head is reduced and does not dislocate, soft tissue is released and repaired, and range of motion is regained. A postoperative radiograph demonstrates screw placement.

Results for "Advanced Reconstruction: Shoulder 2"

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