• Title/Summary/Keyword: Capsulolabral complex

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Anteroinferior Capsulolabral Complex Repair Using Antegrade Suture Passer - Technical Note - (Antegrade Suture Passer를 이용한 전하방 관절낭-관절와순 복합체의 복원술 - 수술 술기 -)

  • Seo, Hyuk-Jun;Cho, Chul-Hyun;Lee, Si-Wook
    • Journal of the Korean Arthroscopy Society
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    • v.17 no.1
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    • pp.95-99
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    • 2013
  • We introduce arthroscopic Bankart repair technique using antegrade suture passer that can effectively restore detached anteroinferior capsulolabral complex for shoulder anterior instability. After diagnostic arthroscopy is performed using posterior, anteroinferior and anterosuperior portals, we confirm Bankart lesion and perform debridement and decortications of anteroinferior glenoid edge and neck. Suture anchor is inserted through anteroinferior portal at 2 mm medial side of glenoid edge (4:30 direction). Scorpion$^{TM}$ loaded suture is directly advanced to detached and retracted anteroinferior capsulolabral complex and the suture is passed at 10~15 mm medial side of detached anteroinferior capsulolabral complex (5:30 direction). The suture is retrieved by Scorpion's hook and then is tied using samsung medical center (SMC) sliding knot technique. Then suture anchors are serially inserted (2:30, 3:30) and capsulolabral complex repair is performed using suture hook and suttle-relay technique. This technique that can obtain anatomical restoration of anteroinferior glenohumeral ligament with proper tension is useful technique to reduce postoperative recurrence and makes it possible for less experienced surgeons.

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Biceps long head tendon revisited: a case report of split tendon arising from single origin

  • Kim, Kyung-Cheon;Rhee, Kwang-Jin;Shin, Hyun-Dae;Byun, Ki-Yong
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 2008.03a
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    • pp.165-165
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    • 2008
  • A 27-year-old, right-hand-dominant woman with a posttraumatic anterior shoulder dislocation 3 months earlier after traYc accident presented because of pain and limited range of motion in the right shoulder. On physical examination, the patient had negative instability tests and a sulcus sign. On arthroscopic examination, a bifurcate long biceps tendon with two limbs was observed about 1 cm distal to the origin in the supraglenoid tubercle. We found no evidence of a tear in the long biceps tendon on probing, and the margin of each limb was smooth and round. Although this anatomic variant may be benign, its presence might be associated with other shoulder pathology. It is interesting to speculate whether the aberrant biceps anatomy in our patient contributed to transfer of injury at dislocation to the rotator cuff rather than to the classic anterior-inferior capsulolabral complex. In addition, recognition of the described anatomic variant on arthroscopy can aid the shoulder surgeon in focusing treatment on the actual pathology.

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Arthroscopic Reconstrucion in Megafrequency of Recurrent Anterior Shoulder Dislocations (관절경을 이용한 고 빈도 재발성 전방 견관절 탈구의 재건술)

  • Ko, Sang-Hun;You, Chong-Il;Cho, Sung-Do;Choi, Chang-Hyuk;Cheon, In-Ho;Woo, Jong-Keun;Kwag, Chang-Yul;Yun, Dong-Jin;Choe, Seong-Won
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.2
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    • pp.194-200
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    • 2005
  • Purpose: To evaluate the short-term follow up outcome and the effectiveness of arthroscopic vertical shift of anteroinferior capsulolabral complex, plication of AIGHLC (anterior band of inferior glenohumeral ligament complex) and thermal capulorraphy, posteroinferior suture plication, rotator interval closure as an adjuncts in recurrent instability of megafrequency with night time dislocation. Materials & Methods: From March 1998 to February 2004, we have had 18 shoulders out of 156. All of the cases have been night time dislocation above more one time. The age were average 29.4$(21{\sim}37)$ year old. The average follow up were 21.1 $(12{\sim}45)$months We checked Rowe score and ROM at pre-operation, post-operation 6 months,1 year & last follow up period. Results: Above good results were 16 cases(88.9%). The excellent were 6 cases, good were 10, fair 1, poor 1. Conclusions: In recurrent anterior shoulder dislocation in greater than 50 frequency, arthroscopic stabilization can be an alternative technique for selected patients against open inferior capsular shift. But more long ter n follow up and large materials will be needed in the future study.

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A Suture Bridge Transosseous-Equivalent Technique for Bankart Lesions with Deficient Bony Stability - Technical Note - (골안정성 결손을 가진 Bankart 병변에 대한 경 골-유사 교량형 봉합술식 - 술기 보고 -)

  • Choi, Chang-Hyuk;Kim, Shin-Kun;Chang, Il-Woong;Chae, Sung-Bum
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.2
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    • pp.179-182
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    • 2009
  • Purpose: Point fixation at the margin of the glenoid is a limitation of conventional arthroscopic stabilization using suture anchors, and does not afford sufficient footprint healing, especially in glenoid bone deficiency. So, we introduce an arthroscopic suture bridge transosseous-equivalent technique for bony Bankart lesions to avoid the technical disadvantage of point contact with anchor fixation and to improve mechanical stability through cross compression of the labrum. Surgical approach: The technique was adapted from the transosseous-equivalent rotator cuff repair technique using suture bridges, which improved the pressurized contact area and mean pressure between the tendon and footprint. After preparation of the glenoid bed by removal, reshaping, or mobilization of the bony lesion, two anchors (3.0 mm Biofastak, $Arthrex^{(R)}$, Naples, FL) were inserted into the superior and inferior portion of the bony Bankart lesion. Using a suture hook, medial mattress sutures were applied around the capsulolabral portion of the IGHL complex to obtain sufficient depth of glenoid coverage. A 3.5 mm pushloc anchor ($Arthrex^{(R)}$, Naples, FL) hole was made in the articular edge of the anterior glenoid rim. distal, suture bridge was applied, and proximal was inserted to mobilize the labrum in the proximal direction. This avoided the technical disadvantage of point contact with anchor fixation and decreased the level of gap formation through cross-compression of the labrum.

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