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Institute of Advanced Orthopedics, MOSC Hospital and Medical College, Kolenchery, Ernakulam, Kerala

Watch Proc – Shoulder Arthroscopy

Arthroscopic Bankart surgery  – for recurrent dislocation of the shoulder joint

A 36year old male patient who presented with recurrent dislocation of the left shoulder joint. This was causing recurrent episodes of pain and disability to the person. He had pain on all activities involving lifting the arm above the head and moving it outwards. Here you can see an Arthroscopic (Key-hole) repair of the torn labrum, called Arthroscopic Bankart surgery. You can see Biocomposite Suture anchors used to fix the torn labrum back to the glenoid bone (cup of the shoulder joint).

This video shows a rare variant of the Bankart lesion (detachment of the glenoid labrum and capsule from the glenoid bone (cup of the shoulder joint). This is called a Perthe’s lesion where the anterior glenoid labrum has a false attachment to the bone. But this does not have biomechanical strength and the shoulder was weak and unstable on movement. He had a superior labram anterior-posterior tear.
In this video you can see suture anchor fixation of the anteroinferior labrum and the superior labrum.

 

Arthroscopic Latarjet procedure, the Metal-free Cerclage tape technique

This video demonstrates the Metal-free cerclage tape technique of Arthroscopic Latarjet procedure for recurrent shoulder dislocation. This procedure is a recent advance in the field of shoulder dislocation surgery and had many advantages over the open technique of Latarjet coracoid transfer.

Advantages of Metal free cerclage tape technique include 1. Less soft tissue dissection 2. Reduced pain 3. Faster recovery 4. safe from head of humerus impingement on the metal screws as in standard Latarjet procedure 5. Minimal scars – better cosmesis 6. Dynamic sling effect of the conjoint tendon as in Latarjet transfer 7. As it is an arthroscopic technique, anterior capsule repair can be done concomitantly providing a smooth surface for the movement of the humeral head, thereby protecting from wear.  Although the learning curve is steep, this technique is being embraced by Shoulder surgeons all around the world for treating shoulder dislocation when bone loss has set in after many episodes of instability of the shoulder. Dr Sujit Jos is an Orthopedic surgeon, Prof and Head, Institute of Advanced Orthopedics, MOSC Hospital and Medical College, Kolenchery, Kochi (Ernakulam), Kerala, India. He is specialised in complex Arthroscopic surgeries of the shoulder, knee and hip joints, and primary and revision Joint Replacement surgeries.

 

Arthroscopic Biceps Tenodesis

Biceps tenodesis is done for a painful biceps tendon which can be seen along with subacromial impingement, superior Labral tears (SLAP tear), or rotator cuff tears.

Arthroscopic knot tying tutorial

Arthroscopic SLAP repair

This video demonstrates the technique of Arthroscopically repairing a Superior Labral tear. A SLAP tear can be debilitating for an over head athlete. It can reduce the over-head throwing power of the arm and can cause severe pain while doing over head sports. An untreated SLAP tear can lead to shoulder impingement and consequent Supraspinatus and Subscapularis tears.

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