Shoulder

Procedure

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

Child (D)

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
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.

This animation demonstrates the arthroscopic bone block cerclage technique for glenoid bone loss, which preserves the integrity of the subscapularis and provides a metal-free fixation of a bone graft using FiberTape® cerclage. The procedural steps show in detail the use of the TransGlenoid drill guide, as well as all the components of the procedure kit.

Free Bone Block Graft

Distal Tibia Allograft Workstation for Glenoid Bone Loss

Bone Block Cerclage