Name: All Suture Technique for Anterior Glenoid Bone Grafting
Uploaded: 2024-05-31T00:00:00.0000000
Duration: T00H05M59S
Description: All Suture Technique for Anterior Glenoid Bone Grafting

Name: All Suture Technique for Anterior Glenoid Bone Grafting

Description: All Suture Technique for Anterior Glenoid Bone Grafting

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Content URL: https://cadmoreoriginalmedia.blob.core.windows.net/47789a34-2fa1-4f9f-ad9f-54b3f2edf78f/All suture technique for anterior glenoid bone grafting.mp4?sv=2019-02-02&sr=c&sig=QyEymbs8z0YzNe2ykygXiC1NP%2Fv9E%2F%2FAgbqOPK6Qfaw%3D&st=2024-11-21T16%3A59%3A44Z&se=2024-11-21T19%3A04%3A44Z&sp=r

Upload Date: 2024-05-31T00:00:00.0000000

Transcript: Language: EN.
Segment:0 .
Iliac crest grafting of the anterior glenoid using an all suture technique. With the patient in the beach chair position, a deltopectoral approach is made and a subscapularis split is used to expose the anterior glenoid with a medially based T capsule ostomy.
With the glenoid neck exposed, any bone loss or malunited fragments can be identified. A saw or burr is used to remove any fragments, flatten the glenoid neck and prepare the surface for grafting. A green cannula obturator is used as a drill guide and is placed on the glenoid neck. The 2.6 mm FibreTak drill is passed through the cannula and through the glenoid to exit on the posterior surface.
A 2.6 mm FibreTak DR anchor is then passed down the cannula and deployed. The same process is repeated inferiorly to provide two anchors in the glenoid neck. The sutures are then separated into four pairs, each containing one fiber wire and one suture tape.
The sutures are then shuttled through the graft using a pds suture as a suture passer. If they are passed as separate pairs, it makes the process easier and it keeps them separated. Once all the sutures have been passed, one pair from the inferior anchor and one pair from the superior anchor are passed through a two hole, 2.7 millimeter tibial plate.
Once all the sutures have been passed, the graft of the plate can then be parachuted down onto the glenoid neck. At this stage, there should be one fibre wire and one suture tape from each anchor inside the plate and the other pair outside the plate. It is now a process of sequentially tying all of the sutures over the plate.
The fiber wire sutures should slide and therefore, it's best to start with these. Initially the plate will rotate a little bit until one pair from the superior and one pair from the inferior anchor are tied, making it stable.
Once the inferior fiber wire sutures are tied down, the plate will sit flush on the graft but there may still be a little bit of play in the whole system. The suture tapes can now be tied and this will have to be using a non sliding knot.
Once the second suture tape pair is tied down, the graft becomes very stable. At this stage, the graft can be assessed for any overhang on the glenoid and any excess can be trimmed with a saw or a burr to make it flush.
To repair the anterior capsule, a 1.6 millimeter FibreTak anchor is inserted on the glenoid face between the two 2.6 millimeter FibreTak anchors that were previously placed. The sutures are then passed through the capsule in a mattress fashion to obtain a repair and any desired capsular shift.
The sutures are then tied down, completing the repair. The completion of the procedure, the graft can be seen to be very stable and the capsule has been repaired.

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