Posterior shoulder instability managed by arthroscopic acromial pediculated bone-block. Technique

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Anatomy

Background:

• Posterior shoulder instability, including recurrent dislocation and subluxation, often requires surgical intervention when conservative treatments fail.
• Psychological contraindications must be assessed before considering surgical options for posterior shoulder instability.

Purpose of the Study:

• To describe a detailed surgical technique for posterior shoulder instability using an acromial bone-block with a pediculated deltoid flap.
• To present an alternative surgical method to iliac bone-grafting for achieving triple shoulder locking.

Main Methods:

• The Kouvalchouk technique involves an acromial bone-block combined with a pediculated deltoid flap for posterior shoulder stabilization.
• Arthroscopy is utilized for joint exploration, diagnosis of associated lesions, and facilitates bone-block placement and capsule reinsertion.
• The procedure involves opening and preserving the posterior capsule to aid in reinsertion.

Main Results:

• The described technique enables "triple shoulder locking" through a blocking effect, a retention hammock from the deltoid flap, and posterior capsule repair.
• Arthroscopy enhances the precision of bone-block positioning and capsule reinsertion, potentially improving outcomes.

Conclusions:

• The acromial bone-block with a pediculated deltoid flap is a viable surgical option for posterior shoulder instability.
• This arthroscopic approach offers a comprehensive solution for stabilizing the shoulder and repairing associated capsular damage.