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Arthroscopic Posterior HAGL Repair Using a Direct Transaxillary Portal.

Sebastian Albers1, Milad Farkhondeh Fal2, Jörn Kircher1,3

  • 1ATOS Klinik Fleetinsel Hamburg, Department of Shoulder and Elbow Surgery, Hamburg, Germany.

Arthroscopy Techniques
|August 3, 2023
PubMed
Summary

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Repairing posterior humeral avulsion of the glenohumeral ligament (HAGL lesion) is complex. An arthroscopic transaxillary approach improves suture anchor placement for better surgical outcomes in shoulder instability.

Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Arthroscopy

Background:

  • Humeral avulsion of the glenohumeral ligament (HAGL lesion) presents surgical challenges, particularly posterior lesions.
  • Conventional open anterior approaches offer limited visualization and access for posterior HAGL lesion repair.
  • Existing arthroscopic techniques may not optimally address the unique anatomical challenges of posterior HAGL lesions.

Purpose of the Study:

  • To describe an alternative arthroscopic transaxillary approach for treating posterior HAGL lesions.
  • To demonstrate a technique for improved suture anchor deployment and positioning.
  • To enhance surgical outcomes for shoulder instability due to posterior HAGL lesions.

Main Methods:

  • Utilized an arthroscopic transaxillary approach for surgical repair.

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  • Focused on deploying suture anchors perpendicular to the humeral bone surface.
  • Aimed for precise anatomical placement of anchors at the inferior humeral ligament insertion.

    • Main Results:

    • The described technique facilitates perpendicular suture anchor deployment.
    • Improved anchor positioning at the anatomic insertion site of the inferior humeral ligament was achieved.
    • This approach potentially overcomes limitations of traditional open anterior methods for posterior HAGL lesions.

    Conclusions:

    • The arthroscopic transaxillary approach offers a viable alternative for posterior HAGL lesion repair.
    • This technique enhances the precision of suture anchor placement, crucial for successful ligamentous repair.
    • Further studies may validate the efficacy and long-term outcomes of this arthroscopic method in managing shoulder instability.