“Arthroscopic technique for management of unusual cartilage defect in the shoulder with BMAC (Bone Marrow Aspiration Concentrate)- a case report"

Shoulder cartilage defects, apart from the more common Hill-Sachs and reverse Hill-Sachs, are rarely described in the literature and there is no consensus on management. We describe the arthroscopic management of an anterosuperior chondral defect of the humeral head in a patient experiencing recurrent shoulder instability following a failed Bankart repair, for which an arthroscopic Latarjet combined with capsulolabral repair and remplissage procedure was planned. The procedure was conducted arthroscopically in a single stage using existing portals created for the Latarjet procedure. Post operative CT scans showed good bony integration and remodelling of the defect and MRI at one year showed satisfactory filling of the cartilage defect as well as complete filling of the Hill-Sachs defect. Prospective clinical and functional evaluation revealed full range of motion of the shoulder, improvement in preoperative Rowe and ASES scores from 30 and 43 respectively to 95 and 98 respectively post operatively at one year follow up. This unique case report supports the efficacy of arthroscopic BMAC application in treating cartilage defects of the humeral head and validates its technical feasibility as well as satisfactory clinico-radiological outcomes when used in conjuncture with Latarjet, capsulolabral repair and remplissage arthroscopically.