Please use this identifier to cite or link to this item: http://docs.prosentient.com.au/prosentientjspui/handle/1/11245
Title: The Safety of a Far Medial Arthroscopic Portal for Anatomic Glenoid Reconstruction: A Cadaveric Study.
Authors: Moga, Iustin
Konstantinidis, George
Wong, Ivan Ho-Bun
Affiliation: Department of Orthopedic Surgery, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada..
Royal Darwin Hospital, Darwin, Northern Territory, Australia..
Dalhousie University, Halifax, Nova Scotia, Canada..
Issue Date: Sep-2018
Citation: Orthopaedic journal of sports medicine 2018-09; 6(9): 2325967118795404
Abstract: An arthroscopic technique for anatomic glenoid reconstruction has been proposed for the treatment of glenohumeral bone loss in patients with recurrent shoulder instability. This technique is proposed as an alternative to open techniques as well as to the technically challenging arthroscopic Latarjet procedure. In arthroscopic anatomic glenoid reconstruction, a distal tibial allograft is inserted through a novel far medial portal, superior to the subscapularis tendon and lateral to the conjoint tendon. To evaluate the safety of the far medial arthroscopic portal for anatomic glenoid reconstruction in a cadaveric study. Descriptive laboratory study. Ten cadaveric shoulder specimens were dissected after inside-out medial arthroscopic portal insertion in the lateral decubitus position for arthroscopic anatomic glenoid reconstruction. A single observer performed 3 measurements on each specimen with a digital caliper (to the nearest 0.1 mm) from the medial portal to neurovascular structures, and the mean (±SD) and the range were calculated. The anthropometric data of the cadaveric specimens were also collected. The mean distances between the far medial arthroscopic portal and sensitive anatomic structures were as follows: 50.79 ± 13.69 mm from the musculocutaneous nerve, 46.28 ± 9.64 mm from the axillary nerve, 6.71 ± 8.52 mm from the cephalic vein, and 48.52 ± 7.22 mm from the subclavian artery and vein. The mean size of the medial arthroscopic portal was 25.60 mm. In all cases, the subscapularis muscle was intact. The far medial arthroscopic portal for anatomic glenoid reconstruction without a subscapularis split presents a minimal risk to most neurovascular structures during bony reconstruction of the glenoid surface in patients with anterior shoulder instability. The only anatomic structure at risk is the cephalic vein, while the axillary and musculocutaneous nerves are at a safe distance away from the portal, based on previous shoulder arthroscopic portal safety studies in the literature. Arthroscopic anatomic glenoid reconstruction using a distal tibial allograft is increasing in popularity for the treatment of anterior shoulder instability with significant bone loss. Being a relatively new technique, the safety of it has yet to be established. This study aimed to demonstrate the safety of a new portal used for arthroscopic anatomic glenoid reconstruction.
URI: http://docs.prosentient.com.au/prosentientjspui/handle/1/11245
DOI: 10.1177/2325967118795404
ISSN: 2325-9671
Type: Journal Article
Subjects: Latarjet
anatomic glenoid reconstruction
axillary nerve
bone loss
cadaveric study
cephalic vein
far medial portal
inside-out
musculoskeletal nerve
portal safety
shoulder arthroscopic surgery
shoulder instability
subclavian artery
subclavian vein
subscapularis split
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