J ISAKOS
November 2024
Background: The inferior glenohumeral ligament (IGHL) comprising the anterior and posterior bands with interposing axillary pouch is an important static stabilizer of anterior translation and external rotation (ER) in the 90-degree abduction position. No literature is available to determine any ideal graft or isometric point for fixation of any graft to replace the functionality of IGHL such that the tensile stress acting on the graft is under the limits of the tensile properties of the graft used for reconstruction.
Methods: Using finite element method analysis (FEM) of the long head of the biceps tendon (LHBT) with modeling and simulation process, the ultimate tensile strength of the LHBT at the different clock positions of the humeral head attachment and angular positions of the humerus were determined through a combination of Taguchi Design of Experiments and simulation using ANSYS (Analysis system) software.
Superior capsular reconstruction is a joint salvage treatment option for retracted irreparable rotator cuff tears in relatively young patients. Various graft options have been described in the literature, including autologous fascia lata graft, synthetic graft, and dermal patches. Superior capsular reconstruction using long head of biceps tendon autograft alone has also been described by few authors.
View Article and Find Full Text PDFIntraoperative vertical coracoid graft fractures during the Latarjet procedure are well-described complications, which typically have a poor prognosis or may necessitate further iliac crest bone grafting for stabilization. The vertical split coracoid fractures are reasoned to be caused by excessive tightening of the screws, poor bone quality, especially in females and the smaller dimension of the coracoid graft. In this technical note, we propose an arthroscopic salvage technique for salvaging the fractured coracoid graft and to avoid the need for additional bone graft, thereby reducing morbidity to the patient.
View Article and Find Full Text PDFIntroduction: We present a case report of an iatrogenic conjoint tendon avulsion fracture following arthroscopic Latarjet and salvage technique to address the complication with a novel double sling technique.
Case Report: A 16-year-old male patient who presented with recurrent instability of the right shoulder was counseled for an arthroscopic Latarjet procedure, taking account of critical glenoid bone loss and his contact sporting activities. An intraoperative coracoid tip fracture occurred, which was managed with the double sling technique.