Arthroscopic Distal Clavicular Autograft for Congruent Glenoid Reconstruction

ABSTRACT: Arthroscopic distal clavicular autograft (DCA) is effective in shoulder instability with glenoid bone loss. The original technique uses an osteochondral autograft, fixed with screws or suture anchors. We developed a modified procedure called “congruent arc DCA” characterized by (1) use of drilling guides to optimize graft positioning and make the all-arthroscopic procedure safer and reproducible; (2) rotation of the DCA of 90° to reach a congruent arc with its undersurface; (3) fixation of the graft with cortical buttons to simplify its intra-articular passage, avoid hardware problems, and facilitate possible revision surgery; and (4) intraoperative use of a suture tensioner to achieve satisfactory compression of the graft and increase its consolidation. Technique Video Video 1 Arthroscopic distal clavicular autograft for congruent glenoid reconstruction. We present our modified procedure called “congruent arc DCA,” characterized by 5 steps: (1) opening the rotator interval, (2) glenoid preparation and drilling, (3) distal clavicle dissection, drilling and osteotomy, (4) clavicle bone graft transfer and fixation, and (5) Bankart repair. The patient is positioned in “lazy” beach chair and arthroscopic images are all from a right shoulder.

SUBMITTER: Boileau P 

PROVIDER: S-EPMC8626581 | biostudies-literature |

REPOSITORIES: biostudies-literature