Shoulder Instability: Reconstruction of Bone Loss at Shoulder Socket With Bone Graft and Suture Animation

Shoulder Instability: Reconstruction of Bone Loss at Shoulder Socket With Bone Graft and Suture Animation

This animation demonstrates a bone block cerclage for the treatment of shoulder instability. This surgical technique adds more bone to the shoulder socket with a bone graft and sutures to provide more stability to the shoulder joint.

Here, we see inside the right shoulder, facing from the side. The front of the shoulder is at the right side of the screen, and the back of the shoulder is at the left side of the screen. The upper arm bone is not shown, so we can see inside the shoulder socket.

First, the area of missing bone from the shoulder socket is measured. A drill hook is inserted and put in place on the shoulder socket. Next, a drill sleeve is inserted, and a drill is used to create 2 small tunnels across the shoulder socket. The drill sleeve and guide hook are removed, leaving the 2 drill bits in place.

Next, 2 holes are drilled through the bone block. The inner pins of the drill bits are removed, which allows wire to be passed through the drill bits and retrieved from inside the shoulder joint. The drill bits are then removed.

Looped sutures are then used to replace the wires. These looped sutures are used to pass thicker suture tape through the shoulder joint and through the holes made in the bone block. Applying tension to the sutures pulls the bone block into the shoulder joint.

The sutures are then tied and gently pulled down to the bone. The sutures are further tightened with a tensioning instrument. Additional knots are made to fully secure the bone block in place.

Then, small sutures and soft body anchors are used to reattach the torn labrum to the new bone added to the shoulder socket. The bone block cerclage is now complete.