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Glenoid drill

Philippe Valenti, Charbel Maroun, Eric Wagner, Jean-David Werthel
The arthroscopic Latarjet procedure is challenging because it can be difficult to place 2 screws parallel to the glenoid surface and a medial portal (dangerous for the brachial plexus) is mandatory. In addition, precise positioning of the coracoid bone block flush with the joint line and in a subequatorial position as recommended is troublesome without the use of a guiding system because of the arthroscopic lens distortion. To improve the reproducibility of the arthroscopic Latarjet procedure and to minimize the risk of nerve complications, we developed a guiding system to optimize the positioning of the coracoid bone block and 2 cortical buttons to facilitate its fixation...
April 2018: Arthroscopy Techniques
John A Ruder, Ephraim Y Dickinson, Nahir Habet, Richard D Peindl, Donald F D'Alessandro, James E Fleischli
PURPOSE: To determine if the depth of anchor insertion affects the biomechanical performance of a 1.5-mm all-suture anchor in glenoid bone. METHODS: A 1.5-mm all-suture anchor was tested in 8 matched pairs of human cadaver fresh-frozen glenoids. Anchors were inserted at 6 different locations and tested at 3 different depths: 21 mm (preset drilling depth), 17 mm, and 13 mm. Cyclic loading and destructive testing was performed. Displacement after 100 and 200 cycles, along with ultimate failure strength, was determined...
May 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Uli Schmiddem, Nael Hawi, Emmanouil Liodakis, Antonios Dratzidis, Manuel Kraemer, Christof Hurschler, Richard Page, Rupert Meller
PURPOSE: A crucial step of the Latarjet procedure is the fixation of the coracoid process onto the glenoid. Multiple problems associated with the fixation have been described, including lesions of the suprascapular nerve due to prominence of the screw or bicortical drilling. The purpose of the present study was to evaluate whether monocortical fixation, without perforating the posterior glenoid cortex, would provide sufficient graft stability. METHODS: Coracoid transfer was performed in 14 scapula models (Sawbones® , Composite Scapula, 4th generation)...
January 13, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
S E Ozgur, R Sadeghpour, T R Norris
INTRODUCTION: Revision shoulder arthroplasty presents many unique and complex challenges when glenoid bone loss is involved. A distorted and medialized anatomy prevents the proper mechanics of the reverse prosthesis with regard to deltoid tension and ultimate function. This paper highlights one surgeon's experience using structural allograft for glenoid bone loss. PATIENTS AND METHODS: In all, 20 patients for a total of 24 surgeries with a medialized glenoid and/or substantial glenoid bone loss of grade IIB or higher were evaluated in this retrospective study...
December 2017: Der Orthopäde
Johannes Barth, Achilleas Boutsiadis, Lionel Neyton, Laurent Lafosse, Gilles Walch
Background: One of the factors that can affect the success of the Latarjet procedure is accurate coracoid graft (CG) placement. Hypothesis: The use of a guide can improve placement of the CG and screw positioning in the sagittal and axial planes as compared with the classic open ("freehand") technique. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 49 patients who underwent a Latarjet procedure for the treatment of recurrent anterior shoulder instability were prospectively included; the procedure was performed with the freehand technique in 22 patients (group 1) and with use of a parallel drill guide during screw placement in 27 patients (group 2)...
October 2017: Orthopaedic Journal of Sports Medicine
Tim Leschinger, Michael Hackl, Eduard Buess, Sebastian Lappen, Martin Scaal, Lars Peter Müller, Kilian Wegmann
PURPOSE: Implantation of a reverse total shoulder arthroplasty (rTSA) places the axillary and suprascapular nerves at risk. The aim of this anatomic study was to digitally analyse the location of these nerves in relation to bony landmarks in order to predict their path and thereby help to reduce the risk of neurological complications during the procedure. METHODS: A total of 22 human cadaveric shoulder specimens were used in this study. The axillary and suprascapular nerves were dissected, and radiopaque threads were sutured onto the nerves without mobilizing the nerves from their native paths...
October 2017: Injury
Diogo M Geraldes, Ulrich Hansen, Jonathan Jeffers, Andrew A Amis
Most glenoid implants rely on large centrally located fixation features to avoid perforation of the glenoid vault in its peripheral regions. Upon revision of such components there may not be enough bone left for the reinsertion of an anatomical prosthesis. Multiple press-fit small pegs would allow for less bone resection and strong anchoring in the stiffer and denser peripheral subchondral bone. This study assessed the fixation characteristics, measured as the push-in (Pin ) and pull-out (Pout ) forces, and spring-back, measured as the elastic displacement immediately after insertion, for five different small press-fitted peg configurations manufactured out of UHMWPE cylinders (5 mm diameter and length)...
December 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Y-Y Won, J S Park, S J Choi, S I Hong
We have developed a flexible drill device that makes arthroscopic transosseous repair possible, and report preliminary results. Twelve patients with post-traumatic anterior inferior glenohumeral instability were selected. SURGICAL TECHNIQUE: the flexible drill device is inserted into the shoulder joint through the posterior portal and the guide pipe unit is placed 5mm posterior to the margin of the anterior glenoid rim. The flexible drill is driven through the glenoid with the power drill, creating a hole in the glenoid...
June 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
Sandra Mathews, Marco Burkhard, Nabil Serrano, Karl Link, Martin Häusler, Nakita Frater, Ingeborg Franke, Helena Bischofberger, Florian M Buck, Dominic Gascho, Michael Thali, Steffen Serowy, Magdalena Müller-Gerbl, Gareth Harper, Ford Qureshi, Thomas Böni, Hans-Rudolf Bloch, Oliver Ullrich, Frank-Jakobus Rühli, Elisabeth Eppler
BACKGROUND: Placement of the glenoid baseplate is of paramount importance for the outcome of anatomical and reverse total shoulder arthroplasty. However, the database around glenoid size is poor, particularly regarding small scapulae, for example, in women and smaller individuals, and is derived from different methodological approaches. In this multimodality cadaver study, we systematically examined the glenoid using morphological and 3D-CT measurements. METHODS: Measurements of the glenoid and drill hole tunnel length for superior baseplate screw placement were recorded to define size of the glenoid and the distance to the scapular notch on cadaveric specimens...
January 10, 2017: BMC Musculoskeletal Disorders
Alexandre Hardy, Philippe Loriaut, Benjamin Granger, Ahmed Neffati, Audrey Massein, Laurent Casabianca, Hugues Pascal-Moussellard, Antoine Gerometta
PURPOSE: The arthroscopic Latarjet procedure has provided reliable results in the treatment of anterior shoulder instability. However, this procedure remains technically challenging and is related to several complications. The morphology of the coracoid and the glenoid are inconsistent. Inadequate coracoid and glenoid preparing may lead to mismatching between their surfaces. Inadequate screws lengthening and orientation are a major concern. Too long screws can lead to suprascapular nerve injuries or hardware irritation, whereas too short screws can lead to nonunions, fibrous unions or migration of the bone block...
January 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
J Pogorzelski, K Beitzel, A B Imhoff, S Braun
OBJECTIVE: Shoulder stabilization. INDICATIONS: Symptomatic recurrent anterior shoulder instability combined with glenoid bone loss of approximately 20-35 % of the glenoid surface, engaging Hill-Sachs lesion and/or previously failed arthroscopic Bankart repair. In patients with a high risk of redislocation (contact sports) or irreparable soft tissue injury the Latarjet procedure can be considered as a first-line treatment. CONTRAINDICATIONS: Contraindicated if arthroscopic Bankart repair is possible...
December 2016: Operative Orthopädie und Traumatologie
T O Klatte, M J Hartel, L Weiser, M Hoffmann, U Wehrenberg, A Heinemann, J M Rueger, D Briem
PURPOSE: For the success of Latarjet procedure a correct graft positioning is mandatory. Furthermore, the correct screw placement is important to avoid cartilage damage and soft tissue irritation. Due to a cadaveric experimental study, the accuracy of graft and screw positioning utilizing a novel drill guide for a minimal-invasive Latarjet procedure was analyzed. METHODS: Five human fresh-frozen shoulder specimens have been treated in accordance with the Congruent-Arc Latarjet technique using the glenoid bone loss set (Arthrex, Naples, FL, USA) with 3...
October 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Felipe Reinares, Jean-David Werthel, Constantina Moraiti, Philippe Valenti
PURPOSE: The first purpose of this study is to measure the distance between the axillary nerve and the exit point of K-wires placed retrograde through the glenoid in the setting of an arthroscopic Latarjet procedure. The second objective is to evaluate whether manual external rotation of the scapula alters that distance. METHODS: In seven fresh-frozen specimens, two 2.0-mm K-wires were drilled through the glenoid using an arthroscopic Latarjet retrograde glenoid guide...
June 24, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Jeffrey S Chen, David Novikov, Daniel J Kaplan, Robert J Meislin
PURPOSE: To directly compare single-loaded suture anchors (SSA) with double-loaded suture anchors (DSA) to help surgeons optimize the operative technique, time, and cost of Bankart repairs. METHODS: A literature review was performed using the PubMed and SCOPUS databases. Studies that directly compared SSA and DSA for Bankart repairs, or indirectly compared them by collecting relevant data despite a different objective, were included. RESULTS: A total of two studies were included, both of which were cadaveric laboratory studies...
July 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Baris Kocaoglu, Tekin Kerem Ulku, Safiye Sayilir, Mehmet Ugur Ozbaydar, Alp Bayramoglu, Mustafa Karahan
PURPOSE: The aim of our study was to evaluate the risk of medial glenoid perforation and possible injury to suprascapular nerve during arthroscopic SLAP repair using lateral transmuscular portal. METHODS: Ten cadaveric shoulder girdles were isolated and drilled at superior glenoid rim from both anterior-superior portal (1 o'clock) and lateral transmuscular portal (12 o'clock) for SLAP repairs. Drill hole depth was determined by the manufacturer's drill stop (20 mm), and any subsequent drill perforations through the medial bony surface of the glenoid were directly confirmed by dissection...
March 29, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Lisa Becks, Corey Gaydos, Nicholas Stroud, Christopher P Roche
INTRODUCTION: Glenoid loosening is one of the most common complications of anatomic total shoulder arthroplasty (aTSA). Numerous glenoid pegged designs exist within the market place; however, little effort has been made to optimize peg geometry, and as a result, there is no consensus regarding the superiority of one design over another. The aim of this study was to determine the impact of peg design on the fixation strength by comparing the force and displacement associated with five different geometries of cemented glenoid components when each is axially displaced from two different densities of polyurethane bone substitute substrates...
December 2015: Bulletin of the Hospital for Joint Diseases
Tom R G M Verstraeten, Bart Berghs, Alexander Van Tongel, David Volders, Lieven F De Wilde
PURPOSE: Successful total shoulder arthroplasty (TSA) requires a correct position of the glenoid component. This study compares the accuracy of the positioning with a new developed glenoid aiming device and virtual three-dimensional computed tomography (3D-CT) scan positioning. MATERIALS AND METHODS: On 39 scapulas from cadavers, a K-wire (KDev) was positioned using the glenoid aiming device. It consists of glenoid components connected to the aiming device, which cover 150° of the inferior glenoid circle, has a fixed version and inclination and is available with several different radii...
October 2015: International Journal of Shoulder Surgery
Valery M Prokhorenko, Sergey M Fomenko, Pavel V Filipenko, Petr S Turkov
INTRODUCTION: One of the main causes of recurrent shoulder instability is a bone defect of the front edge of the glenoid. The available techniques for reconstruction of this bone defect, however, have some disadvantages. OBJECTIVE: The aim of this study was to develop a new method that can reduce the number of postoperative complications and improve the efficiency of surgical treatment of recurrent anterior shoulder instability with glenoid bone defect. MATERIALS AND METHODS: We present here a new method for surgical treatment of post-traumatic recurrent anterior shoulder instability with bony defects using porous NiTi...
January 2015: Folia Medica
Matthew R Lewington, Nathan Urquhart, Ivan H Wong
Shoulder instability can be a challenging condition to treat when it becomes refractory to soft-tissue procedures or when bone loss exceeds 25% to 27% of the glenoid. The Bristow-Latarjet procedure has been developed and popularized to deal with these concerns. Traditionally, the procedure has been performed as an open approach; however, this has been recently supplanted by novel arthroscopic techniques. We present a technique for the procedure performed with the patient in a semi-lateral decubitus position that assists with optimal graft placement on the native glenoid...
June 2015: Arthroscopy Techniques
Gregory S Lewis, Nicole M Stevens, April D Armstrong
BACKGROUND: A substantial challenge in total shoulder replacement is accurate positioning and alignment of the glenoid component. This challenge arises from limited intraoperative exposure and complex arthritic-driven deformity. We describe a novel pin array guide and method for patient-specific guiding of the glenoid central drill hole. We also experimentally tested the hypothesis that this method would reduce errors in version and inclination compared with 2 traditional methods. METHODS: Polymer models of glenoids were created from computed tomography scans from 9 arthritic patients...
December 2015: Journal of Shoulder and Elbow Surgery
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