Whole Glenoid Reconstruction for Multidirectional Instability of the Shoulder

Figures

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  Fig 1. Bone fragments used for glenoid grafting.

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  Fig 2. The tendon graft complex used for glenohumeral ligament reconstruction. The complex is composed of tendons, internal-bracing sutures, and 2 adjustable loops with mini plates.

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  Fig 3. Illustration of the anterior orifices (A), passing lines (B), and posterior orifices (C) of the transhumeral tunnels used for the reconstruction of the anterior and posterior bands of the glenohumeral ligament (right shoulder).

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  Fig 4. Locating the humeral tunnel to accommodate the posterior band of the glenohumeral ligament with a guide for posterior cruciate ligament reconstruction (arthroscopic subanterior deltoid view of right shoulder through lateral portal). (LHB, the long head of the biceps brachii.)

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  Fig 5. Creating the humeral tunnel to accommodate the anterior band of the glenohumeral ligament (arthroscopic subanterior deltoid view of right shoulder through lateral portal).

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  Fig 6. Releasing the inferior capsule from the inferior glenoid (arthroscopic intra-articular view of right shoulder through posterior portal).

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  Fig 7. Creating the transverse glenoid tunnel with a K wire (A) and a drill (B) sequentially (arthroscopic intra-articular view of right shoulder through anterior superior portal). (G, glenoid.)

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  Fig 8. Passing the guide suture through the transglenoid drill (A) and leaving the guide suture in the transverse glenoid tunnel (B) (arthroscopic intra-articular view of right shoulder through anterior superior portal). (G, glenoid.)

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  Fig 9. Passing the guide suture through the subscapularis anteriorly (A) (arthroscopic intra-articular view of right shoulder through anterior superior portal) and find the guide suture at the anterior side of the subscapularis (B) (arthroscopic extra-articular view of right shoulder at the anterior side of the subscapularis through the lateral portal). (Subsc, subscapularis.)

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  Fig 10. Passing the tendon graft through the glenoid tunnel and the subscapularis from the posterior (A) to the anterior (B) sides (arthroscopic intra-articular view of right shoulder through anterior superior portal). (G, glenoid.)

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  Fig 11. The shoulder bone grafting instruments.

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  Fig 12. Illustration of placement of the inferior bone graft (right shoulder).