Arthroscopic Reverse Remplissage for Posterior Instability

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Presentation transcript:

Arthroscopic Reverse Remplissage for Posterior Instability Chad D. Lavender, M.D., Shane R. Hanzlik, M.D., Sara E. Pearson, Ph.D., Paul E. Caldwell, M.D.  Arthroscopy Techniques  Volume 5, Issue 1, Pages e43-e47 (February 2016) DOI: 10.1016/j.eats.2015.09.005 Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 1 Sagittal and axial views of the shoulder show traditional portal placement for shoulder arthroscopy as well as the reverse Hill-Sachs lesion associated with posterior instability. Arthroscopy Techniques 2016 5, e43-e47DOI: (10.1016/j.eats.2015.09.005) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 2 Arthroscopic view of the right shoulder in the lateral decubitus position from the posterior portal with a 70° arthroscope visualizing the subscapularis tendon and humeral head. Arthroscopy Techniques 2016 5, e43-e47DOI: (10.1016/j.eats.2015.09.005) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 3 Arthroscopic view of the right shoulder in the lateral decubitus position from the posterior portal with a 70° arthroscope visualizing the reverse Hill-Sachs lesion. Arthroscopy Techniques 2016 5, e43-e47DOI: (10.1016/j.eats.2015.09.005) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 4 Arthroscopic view of the right shoulder in the lateral decubitus position from the posterior portal with a 70° arthroscope visualizing the first anchor placement within the reverse Hill-Sachs lesion in preparation for a reverse remplissage procedure. Arthroscopy Techniques 2016 5, e43-e47DOI: (10.1016/j.eats.2015.09.005) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 5 Arthroscopic view of the right shoulder in the lateral decubitus position from the posterior portal with a 70° arthroscope visualizing the second anchor placement within the reverse Hill-Sachs lesion in preparation for a reverse remplissage procedure. Arthroscopy Techniques 2016 5, e43-e47DOI: (10.1016/j.eats.2015.09.005) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 6 Arthroscopic view of the right shoulder in the lateral decubitus position from the posterior portal with a 70° arthroscope visualizing suture retrieval in a retrograde fashion through the subscapularis tendon in preparation for a reverse remplissage procedure. Arthroscopy Techniques 2016 5, e43-e47DOI: (10.1016/j.eats.2015.09.005) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 7 Arthroscopic view of the right shoulder in the lateral decubitus position from the posterior portal with a 70° arthroscope visualizing sutures passed through the subscapularis tendon in preparation for a reverse remplissage procedure. Arthroscopy Techniques 2016 5, e43-e47DOI: (10.1016/j.eats.2015.09.005) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 8 Sagittal and axial views of the shoulder show placement of the double-loaded suture anchors into the reverse Hill-Sachs lesion with passage of the sutures through the subscapularis tendon. Arthroscopy Techniques 2016 5, e43-e47DOI: (10.1016/j.eats.2015.09.005) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 9 Arthroscopic view of the right shoulder in the lateral decubitus position from the posterior portal with a 70° arthroscope visualizing sutures tied on the anterior aspect of the subscapularis tendon after completion of a reverse remplissage procedure. Arthroscopy Techniques 2016 5, e43-e47DOI: (10.1016/j.eats.2015.09.005) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 10 Sagittal and axial views of the shoulder show completion of the reverse remplissage procedure with the sutures tied down to fill the reverse Hill-Sachs with the subscapularis tendon. Arthroscopy Techniques 2016 5, e43-e47DOI: (10.1016/j.eats.2015.09.005) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions