Arthroscopic Bone Block Cerclage: A Fixation Method for Glenoid Bone Loss Reconstruction Without Metal Implants

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomedical Engineering

Background:

• Large glenoid bone defects in shoulder instability increase arthroscopic Bankart repair failure rates.
• Current bone graft techniques often use metal fixation, which may lead to graft resorption.
• A metal-free fixation method is needed to improve graft survival and long-term outcomes.

Purpose of the Study:

• To describe a novel arthroscopic technique for anatomical glenoid reconstruction.
• To utilize a metal-free fixation method to potentially mitigate bone graft resorption.
• To evaluate the feasibility and stability of this technique for shoulder instability.

Main Methods:

• Arthroscopic anatomical reconstruction of the glenoid using a tricortical iliac crest autograft.
• Metal-free fixation employing two ultra-high-strength sutures (FiberTape Cerclage System).
• Completion of the procedure with a capsulolabral reconstruction.

Main Results:

• The described technique allows for anatomical glenoid reconstruction without metal implants.
• Ultra-high-strength sutures provide substantial stability to the bone graft.
• This approach aims to reduce complications associated with metal fixation, such as graft resorption.

Conclusions:

• This metal-free arthroscopic technique offers a viable alternative for glenoid bone reconstruction in shoulder instability.
• Suture fixation provides adequate graft stability, potentially improving bone graft incorporation and long-term success.
• Further studies are warranted to evaluate the clinical outcomes and durability of this approach.