Shoulder

Procedure

The Glenoid Bone Loss Set includes unique instrumentation and implants to make the open Latarjet technique more consistent and repeatable. TheCongruent Arc Latarjet Technique developed by Dr. Stephen Burkhart, Dr. Ian Loand Dr. Sven Lichtenberg involves dissecting the CA ligament and pectoralis minor from the coracoid and performing a coracoid osteotomy. A grasping CoracoidDrill Guide is used to prepare two parallel holes in the coracoid graft which then mate with one of the Glenoid Parallel Drill Guides. The cannulated guide allows the graft to be positioned on the glenoid while guide wires are placed through the graft and into the glenoid. Self-drilling, self-tapping 3.75 mm titanium cannulated screws are then placed over the guide wires securing the graft into position.

Congruent Arc Latarjet

Latarjet/Coracoid Process Transfer

Human

Secondary (C)

Treatment of shoulder instability due to glenoid bone loss can be challenging. Common reconstructive techniques include the Latarjet procedure (coracoid transfer) or glenoid augmentation using autograft iliac crest. Dr. Matthew Provencher has described an alternative that uses fresh distal tibia allograft (DTA).1 The lateral portion of the distal tibia is a great match to the patient’s glenoid because it has similar curvature, dense bone, and cartilage.
The Distal Tibia Allograft Workstation is used along with the instrumentation and cannulated screws from the Arthrex Glenoid Bone Loss Set. It allows the surgeon to use trials to determine the desired size and shape of the bone block and then provides a set of simple cutting guides to precisely machine the DTA to match the trial.
Reference
1. Provencher MT, et al. Arthroscopy. 2009;25(4):446-452. doi: 10.1016/j.arthro.2008.10.017.

Distal Tibia Allograft Workstation for Glenoid Bone Loss

Bone block cerclage is an innovative arthroscopic surgical technique that preserves the integrity of the subscapularis and provides a metal-free fixation of the bone graft.1 Two interconnected FiberTape® and TigerTape™ cerclage sutures provide firm compression of the graft and strong fixation that minimizes construct displacement at high loads.2, 3
The FiberTape Cerclage for Glenoid Bone Loss Implant System contains all the necessary implants and disposables for the procedure (except capsulolabral repair anchors). To help provide a reproducible surgical technique, the kit includes an arthroscopic measuring probe, two 3-mm cannulated drills of different lengths to facilitate unobstructed drilling, and the MegaLoader suture-passing loop to aid in the passage of sutures into instruments and bone grafts.
References
1. Hachem AI, Del Carmen M, Verdalet I, Rius J. Arthroscopic bone block cerclage: a fixation method for glenoid bone loss reconstruction without metal implants. Arthrosc Tech. 2019;8(12):e1591-e1597. &nbsp;doi:10.1016/j.eats.2019.08.014
2. Bone Block Graft Fixation for Glenoid Bone Loss: A Comparative Study of FiberTape® Cerclage vs Endobutton Constructs, LA1-000140-en-US_A, Arthrex Naples, FL; 2024.
3. Ritter D, Hachem AI, Scheibel M, Raiss P, Denard PJ, Campagnoli A, Wijdicks CA, Bachmaier S. Primary Stability and Bone Contact Loading Evaluation of Suture and Screw based Coracoid Graft Fixation for Anterior Glenoid Bone Loss. Am J Sports Med. 2023 Sep;51(11):2858-2868. doi: 10.1177/03635465231188976. Epub 2023 Aug 18. PMID: 37656204.

Glenoid Bone Loss

Latarjet/Coracoid Process Transfer

Free Bone Block Graft