We only have a few minutes left, so this is the first case. This is a 16-year-old contact athlete, hockey player. He had a dislocation, trainer reduced, then he was doing trampoline for fun and dislocated again, had to go to the ER that time. He went back to sports, he plays hockey, football, a few more dislocations, continues to be apprehensive with activities, and wants to keep playing these ice hockey and football. This patient is ligamentously lax, 6 out of 9 baton, sulcus, posterior translation is fairly similar, he's apprehensive but not in the mid-range. So we'll kind of skip to the imaging in the interest of time. Skeletally approaching maturity in terms of his x-rays, it's hard to make much of the axillary view in my opinion, my x-ray tech wasn't their best day. And on the MRI, this is one where you see a nice Bankart lesion, not a terribly large hill sax on this view. And the glenoid, I think perhaps there's some mild bone loss, but not too bad. He had a few more dislocations and came back again, so I wanted to get a CT to see if anything had changed. So this is what his CT looks like. Rachel, do you have any thoughts on that one? Yeah, I think Greg, this is a challenging scenario because of his age at 16, but certainly this attritional bone loss, and I'm sure there's a little bony fleck down the anterior face of the glenoid there, but this makes me concerned, just eyeballing it, I think you're approaching about 15%, maybe 12 to 15% if not more. So I have many concerns about this glenoid. Yeah, I think that's exactly right. So this patient is a setup for all the risk factors to fail, a pure arthroscopic Bankart, young contact athlete, ligamentous laxity, somewhat, and some kind of borderline bone loss. So we discussed some options. Any votes on the panel of what you would do for this guy or what you would recommend? And I'll be brief, but one thing, if you look at his CT, the ONFOS view you had, the 3D Yes, maybe the measurements, 13% bone loss, but the position of that bone loss is not great. That's one where even if it's 5% or 10%, the location, I think, probably has some relevance too. So in my mind, this is going to be a bony procedure. He's young. He's got open physis even, a little bit of a physio scar. So I mean, this is a younger guy. So most of the time I'll do a Latter Jay for these just because we know we have long-term outcomes on these. But I do wonder if this is a better case for some sort of more anatomic reconstruction with an allograft. And hopefully you're going to show a scope allograft for this, but we'll see. Any other votes? Everyone on the same page? Open Bankart maybe? I think he's a candidate for an open Bankart. I mean, he's 16. It's always hard to pull the trigger on a Latter Jay, in my opinion, on a 16-year-old. But his bone loss is a little concerning. And certainly he would do great with a Latter Jay. This is also one, Greg. There's currently a multi-center international trial called the STABLE study that is ongoing right now that is enrolling first-time surgery patients, recurrent instability, comparing arthroscopic Bankart with or without REM plasage to an open Latter Jay. And I think that study is currently enrolling, but that's going to be a great tool or a great set of data for us to help make this particular clinical decision. But I agree with both of what my co-panelists said. I like the Latter Jay because we know it's going to work in this patient population. I don't like Latter Jay because he's so young, and we know the potential for complications. But I'm leaning toward Latter Jay. Yeah, I think that hits all the main points there, and we're out of time. So he did have a Latter Jay and did well, good track record. And he had good healing on the x-rays, got back to sport. He didn't have full bench press and slight lack of external rotation, but otherwise he was happy and stable. Thank you all. We're short on time, so everyone have a great day.

16-year-old contact athlete

shoulder dislocations

ligamentous laxity

bone loss

treatment options