IC 10-2026-Innovations in the Treatment of Bone Loss in Anterior Shoulder Instability-IC 10-2026-Innovations in the Treatment of Bone Loss in Anterior Shoulder Instability

Video Transcription

Video Summary

This session featured a panel of shoulder instability experts discussing how to optimize surgical treatment for anterior instability and glenoid bone loss.<br /><br />Jeff Grantham reviewed the arthroscopic Bankart repair, emphasizing patient selection, careful pre-op assessment, and evaluating the entire labrum, including often-missed posterior extension. He stressed key technical points: place anchors low, ideally to the 6 o’clock position or below, use at least three anchors, and consider even more when posterior extension is present. He noted that knotless vs knotted, simple vs mattress, and tape vs wire generally show little clinical difference, so surgeons should use what they do best. He also discussed the ongoing role of open stabilization in select cases due to potentially lower recurrence, though with possible loss of motion.<br /><br />Tom Hackett presented his open Latarjet technique, focusing on safety and reproducibility. He highlighted protection of the musculocutaneous and axillary nerves, careful exposure, coracoid preparation, glenoid flattening, and rigid screw fixation. He also advocated restoring the capsule and using the coracoacromial ligament for reinforcement.<br /><br />JT Tokus focused on arthroscopic button fixation and arthroscopic bone-block techniques, arguing these may eventually replace screws because they are safer, graft-agnostic, and easier to reproduce. He emphasized that bone grafts must recreate glenoid concavity and that compression and construct stability are critical.<br /><br />Ivan Wong described the evolution of the Halifax technique for arthroscopic glenoid bone reconstruction. He argued that bone graft sizing should be based on restoring normal glenoid anatomy and that remodeling is predictable when the graft is properly shaped and fixed. He emphasized remote teaching and preceptorship as ways to spread the technique.<br /><br />The panel repeatedly returned to one theme: treat bone loss directly, address bipolar lesions when needed, and choose the most reproducible operation for the surgeon’s skill set.

Keywords

shoulder instability

anterior instability

glenoid bone loss

Bankart repair

Latarjet procedure

arthroscopic bone-block

glenoid reconstruction

bone graft fixation

capsular repair

surgical technique