Deepak N Bhatia

• MBBS, MS(ORTH), DNB (ORTH)
• Professor (Adj) of Orthopaedic Surgery (AHERF)and Consultant at SportsDocs

Background Concavity compression is an important glenohumeral stabilizing factor, and recent studies suggest that peripheral glenoid bone loss creates the most relevant change in stability. This study analyzed change in bony shoulder stability ratio (BSSR) with sequential anterior glenoid bone loss (0-40% width), and with reconstructive bone graft...

Background Current treatment paradigms for anterior shoulder instability are based on radiological measurements of glenohumeral bone defects, and mathematical calculation of glenoid track is used to classify lesions into “on-track”, and “off-track” morphology. However, radiological measurements have shown high variability, and glenoid track widths...

Background Distal biceps tendon (DBT) pathology is a spectrum that ranges from tendinopathy to complete retracted ruptures, and surgical treatment is usually performed via open approaches. The purpose of this study was to analyze safety and long-term outcomes of all-endoscopic surgery for entire spectrum of primary DBT pathology. The hypothesis wa...

Distal biceps pathology is a common cause of pain and weakness in athletes, and the spectrum of pathology ranges from tendinosis to high-grade tears or complete ruptures. The tendon insertion is difficult to examine and palpate precisely due to long anatomical course that spans various layers in the arm and forearm. Clinical evaluation of the dista...

The distal biceps tendon (DBT) is often involved in anterior elbow pain, and open or endoscopic surgery may be indicated as a solution for treatment of the biceps pathology. Comprised of short and long head tendons, the DBT inserts into the radial tuberosity. There are several pathologies including: tendinopathy and enthesopathy, bicipitoradial bur...

Elbow bicipitoradial bursitis and partial distal biceps tendon (DBT) tears are a result of chronic overuse or other infective/inflammatory pathology and may be refractory to conservative treatment. The all-endoscopic approach provides minimally invasive access to the bursal space and DBT, and diagnostic and therapeutic procedures can be performed u...

The all-endoscopic distal biceps repair is a minimally invasive technique for acute and chronic retracted tendon tears. The procedure involves endoscopic mobilization and retrieval of the retracted tendon using arm endoscopy. The tendon is then shuttled through safe zones into the deeper plane of the cubital fossa and is repaired to the tuberosity...

A chronic perilunate dislocation is a disabling wrist injury that involves complete midcarpal separation and loss of contact between the lunate and capitate for a period of 6 weeks or more. Arthroscopic reduction is possible after perilunate adhesiolysis and percutaneous K-wire stabilization of the carpal rows maintains the reduction until soft tis...

Arthroscopic elbow adhesiolysis is an effective intervention for refractory elbow stiffness and adequate anterior capsulectomy is a crucial step in the procedure. Anterior capsulectomy is usually performed using an inside-out technique; however, joint access is difficult in severe stiffness and altered neurovascular relationships may result in iatr...

Endoscopic-assisted distal biceps tendon (DBT) procedures are performed by using a single anterior incision similar to the open surgical approach for DBT tears [1–4]. The arthroscope and working instruments are used via the same incision during the procedure. Endoscopic magnification via the incision permits clear visualization of the anatomy and o...

The distal biceps tendon (DBT) anatomy is complex; the tendon passes through different planes across the arm and cubital fossa and inserts into a distinct footprint at the bicipital tuberosity. The DBT is closely related to several vital neurovascular structures along its course, and these structures are potentially at-risk during open and endoscop...

Benign tumours and tumour-like lesions are occasionally seen in the intra-articular region of the elbow and clinically present with chronic disabling pain and progressive stiffness. Arthroscopic excision is possible when the lesion is focal and in an accessible location. This chapter presents the arthroscopic findings and technique for excision of...

The elbow is a complex anatomical region formed by a multilayered soft-tissue sleeve of muscles, ligaments, and neurovascular structures. The anatomical locations of these structures are unpredictable due to paucity of anatomical landmarks and frequent variations; to add to this variability, dynamic movement at the joint further changes the surface...

Ganglion cyst of the elbow is an uncommon benign lesion and surgical excision is necessary for a symptomatic and progressively enlarging cyst. Arthroscopic transarticular cyst excision is a minimally invasive technique and is performed using standard portals and intraoperative anatomical landmarks for safety. A 70° arthroscope is used for “cystosco...

Triceps tendon tear is an uncommon injury and is usually associated with systemic diseases and anabolic steroid use. Surgical repair is necessary to restore strength and optimal function. Transosseous repair of triceps tendon is an all-suture repair technique that can be configured to provide a broad footprint-like approximation at the olecranon. T...

Metacarpal head fractures are infrequent sports injuries and accurate reduction and fixation of these intraarticular fractures is necessary. Metacarpophalangeal joint (MCP) arthroscopy provides excellent visualization of the fracture geometry and evaluation of soft-tissue injuries. Accurate articular reduction and fixation with percutaneous K-wires...

Partial tears of the distal biceps tendon (DBT) are overuse injuries and surgical intervention may be necessary for symptomatic relief. The two-portal “all-endoscopic” approach is a safe and minimally invasive procedure for diagnosis, classification, and definitive treatment of partial DBT tears and avoids the necessity of a more extensive open pro...

Chronic ruptures of the distal biceps tendon (DBT) are characterized by severe retraction and a severe Popeye deformity. Often these tears are irreparable due to muscle atrophy, tendon degeneration, and deficient tendon length. Surgical intervention involves extensive open procedures using autografts or allografts for augmentation and restoration o...

Posterior elbow impingement is an overuse injury associated with valgus-extension overload in several throwing and non-throwing sports. Impingement pathology is variable and includes olecranon tip overgrowth, trochlear and fossa osteophytes, synovial hypertrophy, osteophyte fracture, and olecranon stress fractures. Arthroscopy is useful for evaluat...

The pisiform bone forms a mobile articulation with the triquetrum that is stabilized by several ligaments and flexor carpi ulnaris tendon. The inherent mobility predisposes the joint to instability and wear and results in ulnar-sided wrist pain. Arthroscopy of the PTJ is a minimally invasive approach to evaluation and treatment of PTJ pain and resu...

The metacarpophalangeal joint (MCP) is frequently involved in sports injuries, and in degenerative and inflammatory conditions of small joints of hand. MCP arthroscopy is useful for diagnostic evaluation and advances in small joint instrumentation now permit therapeutic arthroscopic procedures as well. This chapter presents the portal placement and...

Common extensor tendinopathy (lateral epicondylitis/tennis elbow) is an overuse enthesopathy of the extensor carpi radialis brevis (ECRB) and extensor digitorum communis (EDC) tendons. Refractory lateral epicondylitis with disabling symptoms often necessitates an open or arthroscopic debridement of the pathology. The arthroscopic anatomic insertion...

Volar dislocation of the distal radioulnar joint (DRUJ) is an unusual injury and occasionally may be irreducible. Arthroscopic reduction is a minimally invasive alternative for mobilization and reduction of the impacted ulnar head and percutaneous transfixation K-wires maintain the reduction until soft tissues have healed. This chapter describes th...

Arthroscopy of the small joints of the hand has evolved with advances in arthroscopes and instruments. Arthroscopic access to trapeziometacarpal (TMJ), metacarpophalangeal (MCP), and the proximal and distal interphalangeal joints (PIP, DIP) is difficult due to the narrow joint spaces and proximity to neurovascular structures and tendons. Specialize...

Intraosseous ganglion (IOG) cysts in the lunate can be decompressed using open and arthroscopic approaches. A direct “cystoscopic” approach to the IOG is minimally invasive and provides excellent visualization of the cyst from within. Direct visualization access is obtained via a 3 mm cortical tunnel in the lunate, and ensures complete intracystic...

Arthroscopic radial head resection is a minimally invasive alternative to open excision in acute fractures and chronic pathology of the radiocapitellar joint. Access to the entire radial head via standard portals is difficult and the “radial head portal” devised by the author provides safe access for rapid resection and removal of large fragments....

Radial neck fractures are common injuries in children. Surgery is necessary for displaced fractures that cannot be closed reduced; however, open surgery is associated with suboptimal outcomes and potential complications. Arthroscopic fixation of radial neck fractures is a minimally invasive technique for repositioning the radial head in correct ali...

Elbow surgery has advanced rapidly in the last decade, and several new techniques offer the advantages of better outcomes and minimal invasiveness. The process of developing a new technique is simplified by application of the six key concepts. Any new technique should be performed in a safe manner and ideally first in a cadaveric model. There must...

Capitellum fractures are uncommon injuries and osteosynthesis is necessary for displaced fractures. Arthroscopic capitellum excision is indicated in comminuted fractures and those with inadequate bone for stable fixation. Arthroscopy is also useful for removal of fixation screws and capitellar debridement in postsurgical collapse and avascular necr...

Degenerative arthritis of trapeziometacarpal joint (TMJ) often necessitates surgical management and trapezium-sparing procedures are associated with satisfactory outcomes. Arthroscopic partial trapeziectomy is performed via specialized TMJ portals; approximately 4–6 mm of distal trapezium is excised and peripheral ligaments and capsular attachments...

Thenar endoscopy is an evolving technique that may be used for treatment of specific pathological conditions involving thenar musculature and deep spaces. Proximal and distal thenar portals provide access to intermuscular planes and intramuscular cysts. “Cystoscopic” visualization is useful for obtaining biopsy of cyst tissues under direct vision a...

The diagnosis of chronic elbow instability is based on meticulous clinical and radiological evaluation. Arthroscopy is a valuable adjunct to clinical signs and imaging, and an alteration in arthroscopically visualized radiocapitellar and ulnotrochlear relations after external manipulation can be quantified. This chapter presents a ten-point arthros...

The all-endoscopic distal biceps approach is a safe and reproducible technique for management of distal biceps pathology. The technique is based on portals placed in safe zones around the complex cubital-fossa anatomy for extra-articular viewing and working. This chapter classifies portals used in the all-endoscopic approach and the associated neur...

Arthroscopic surgery of the elbow, wrist, and hand is evolving rapidly, and there has never been a more exciting time to be a surgeon of the upper limb. What began as simple intra-articular visualization has evolved to complex minimally invasive reconstruction, and procedures that were once exclusively the domain of the subspecialist are becoming i...

Arthroscopy in scaphoid fracture fixation has the advantage of visualization of the fracture reduction and bone grafting the fracture site if necessary. In most arthroscopic techniques, fixation is performed by passing the screw percutaneously from volar or dorsal aspects. Arthroscopic fixation via standard dorsal portals is difficult as the proxim...

This book explores the numerous recent advances in arthroscopic and endoscopic surgery of the smaller joints of the upper extremity – elbow, wrist, and hand. Providing readers with all necessary information, i.e. relevant surgical anatomy and a clear description of technical steps, it uniquely and comprehensively presents arthroscopic and endoscopi...

Surgical repair of massive and chronic rotator cuff tears is difficult due to tendon retraction and severe atrophy, and the resultant retear rate in the structurally weak tendons is high. Commercially available patches and bioinductive scaffolds have been used to provide strength and superior healing environment in partial and complete rotator cuff...

Rotator cuff repairs are associated with suboptimal outcomes and possibly greater incidence of retears if the biological healing environment is compromised. Strategies to optimize tendon–bone healing include the use of bioinductive scaffolds and regenerative stem cell therapy. The subacromial bursa has been shown to have significant pluripotent ste...

Dislocations of the first metatarsophalangealjoint are rare, and recurrent dislocations unique. A national-level Kabaddi player dislocated his right first metatarsophalangeal joint while playing a game bear footed. After self-manipulative reduction, he had multiple dislocations. He reported after a year of injury with complaints of recurrent medial...

Background Distal biceps endoscopy has emerged as a minimally invasive alternative to open procedures for distal biceps tendon (DBT) pathology. The purpose of this study was to systematically describe the static and dynamic appearance and variations of the DBT insertional region using a standardized endoscopic technique and dissection in healthy ca...

Abstract All patients with acute complete distal biceps tendon ruptures who are not low demand or medically unfit to proceed with surgery are offered operative repair. This restores arm shape, supination strength and function, and decreases their cramping symptoms. Surgical repair technique varies significantly depending on location and training ce...

Shoulder arthroscopy has evolved significantly over the past decade. Treatment algorithms have evolved in sync with results from cadaveric, biomechanical, and clinical studies, and newer minimally invasive and biomechanically proven surgical techniques have replaced suboptimal procedures. Advances in arthroscopy have influenced three key aspects of...

Distal biceps tendon (DBT) insertion on the elbow bicipital tuberosity is usually bifurcated into distinct long and short head components, and occasionally the tendon may insert as a single unit. A previously undescribed trifurcate insertion of the DBT was observed during anatomical dissections; this new anatomical finding involved 3 distinct divis...

Lateral epicondylitis is a common overuse enthesopathy of the extensor carpi radialis brevis (ECRB) that can infrequently result in a recalcitrant disabling and painful condition. Surgical intervention is necessary if conservative treatment fails to provide relief, and open and arthroscopic approaches have been described. Arthroscopy provides a com...

Radial head fractures often require excision in the acute or chronic setting. Elbow arthroscopy is useful for removal of comminuted fragments in acute isolated radial head fractures. Similarly, arthroscopic resection of a malunited and incongruous radial head is a minimally invasive method for management of chronic radiocapitellar pathology. Arthro...

Biceps endoscopy is a new frontier in minimally invasive elbow surgery. The technique was originally used for diagnostic evaluation of distal biceps pathology only and has now evolved into an all-endoscopic procedure with therapeutic applications. Endoscopic techniques are useful for debridement and reinsertion of partial distal biceps tears, and c...

Biceps endoscopy is a minimally invasive procedure for diagnosis and definitive treatment of a wide variety of distal biceps tendon (DBT) pathology. The “all-endoscopic” approach devised by the author is a new and safe technique for repair and reconstruction of distal biceps tears. The “parabiceps portal” visualizes the entire repair process that i...

The distal biceps tendon (DBT) anatomy is complex, and its structural and insertional morphology has surgical implications. The DBT has long and short tendon components, and these show three variable insertional footprints into the radial tuberosity. The DBT insertion passes through the proximal radioulnar space (RUS) during dynamic rotation, and a...

Anterior shoulder instability in athletes is a complex problem and necessitates accurate pre- and intra-operative assessment of soft-tissue and bony pathology. Significant bone loss on the glenoid or humeral head predisposes to failure of soft-tissue repair, and bone grafting procedures are necessary to stabilise the shoulder. Recent research has f...

Objectives This study analysed the change in positional relationship of major neurovascular (NV) structures with the distal biceps tendon (DBT) insertion with dynamic rotation. Methods Fresh frozen cadaveric upper extremities (n=10) were dissected to expose DBT and five major NV structures (ulnar artery (UA), radial artery (RA), median nerve (MN),...

Background This study analyzed the alteration in glenoid articular geometry with increasing anterior bone loss, as well as its subsequent correction with 2 modifications of the Latarjet procedure. Methods Anterior defects were simulated by creating glenoid osteotomies (10%, 20%, 30%, and 40%), and defects were reconstructed using 2 Latarjet modifi...

Full thickness rotator cuff tears often progress to an "irreparable" stage that is defined as (a) chronic pseudoparalysis with (b) multiple tendon involvement, (c) atrophy and (d) fatty infiltration of grade 3 and 4, (e) reduced acromiohumeral interval, and (f) severe mediolateral retraction and adherence. Arthroscopic or open repair often results...

Full thickness rotator cuff tears often progress to an "irreparable" stage that is defined as (a) chronic pseudoparalysis with (b) multiple tendon involvement, (c) atrophy and (d) fatty infiltration of grade 3 and 4, (e) reduced acromiohumeral interval, and (f) severe mediolateral retraction and adherence. Arthroscopic or open repair often results...

Distal biceps pathology spectrum includes overuse tendinosis, partial tears, and complete rupture. Open approaches often necessitate excessive retraction and dissection, and are associated with complication rates ranging between 7% and 40 %. An All-Endoscopic approach to the distal biceps was hypothesized and developed using a series of cadaveric s...

Anterior shoulder instability has a wide spectrum of pathology ranging from labral tears to severe glenoid and humeral defects. Treatment strategies involve labral repair, remplissage, and bone grafting procedures. Algorithms for decision-making are complex and evolving. This paper presents our treatment strategy (Integrated algorithm) for anterior...

Common extensor tendinopathy (Tennis elbow) that has persisted and progressively worsened over 6 months or more, and is unresponsive to physical therapy and multiple injections (local cortisone, PRP) is regarded as a refractory condition. Arthroscopic release techniques have been described for debridement and release of the ECRB tendon. Accurate id...

Background: This cadaveric study was designed to analyze the safety of endoscopic repair of distal biceps tendon (DBT) tears using 2 reattachment techniques. We evaluated the proximity of neurovascular struc- tures to endoscopy portals; iatrogenic injury to neurovascular, musculotendinous, and osseous structures; and changes in compartment pressure...

Purpose: Distal biceps tendon (DBT) injuries often require surgical intervention. Current treatment strategies use open surgical approaches to debride and repair the tendon. Endoscopic techniques have been suggested, however, the safety and feasibility of performing an endo- scopic procedure in the upper forearm has not been eval- uated. The purpos...

Osteoid osteoma has been reported infrequently around the elbow joint, and is usually treated with radiofrequency ablation or open excision. Elbow arthroscopy is useful for excision of accessible lesions, and the accompanying elbow stiffness can be treated concurrently. This report describes an arthroscopic excision of an osteoid osteoma located in...

ignificant bone defects of glenohumeral joint play an important role in the management of shoulder instability. Bony instability is an important cause of failed soft-tissue repair and recurrent episodes of shoulder dislocations. Bony instability can also be associated with labral (superior and posterior) tears, humeral avulsion of glenohumeral liga...

Proximal humerus fracture fixation may be complicated by persistent postsurgical stiffness or implant-related problems. Arthroscopic plate removal is a cosmetic and functionally beneficial procedure; however, the procedure is technically difficult in the presence of severe subdeltoid scarring. The technique described here shows an arthroscopic subd...

Purpose To quantify and assess the relationship between the insertional dimensions of the distal biceps tendon (DBT) and radioulnar space (RUS) in 3 rotational positions. We hypothesized that in all positions RUS would be adequate for the DBT and would remain adequate even after an incremental increase (1 to 3 mm) in tendon thickness. Methods Elev...

Distal biceps tendon (DBT) ruptures are infrequent injuries that result in pain, weakness, and cosmetic deformity. Severe retraction of the ruptured DBT can occur at the time of injury, or in chronic neglected ruptures, and surgical exposure is performed using a single incision or a 2-incision technique. The technique presented here describes an en...

Purpose The purpose of this study was to describe neurovascular structures-at-risk during establishment of five portals for access to distal biceps tendon (DBT) in cubital fossa, and to establish relative safety of these portal sites for such access. We hypothesized that all five portals are safe for endoscopic DBT exploration. Methods Ten fresh fr...

Displaced radial head fractures are treated with open reduction and internal fixation using implants. Failure of fixation may occur in the presence of comminution and in multifragmentary fractures; open surgical approaches are necessary for removal of the implants and radial head resection. Arthroscopic radial head resection has been described as a...

An acute perilunate wrist injury that is unreduced for more than 6 weeks results in severe disability, and even open reduction with stabilization through wide dorsal and volar approaches is technically challenging. This report describes an arthroscopic technique for reduction and percutaneous wire stabilization of a chronic perilunate wrist disloca...

Distal biceps rupture is associated with significant functional disability, and surgical treatment involves open or endoscopic-assisted repair of the ruptured tendon through an anterior incision. This report describes an endoscopic approach that is performed with 2 portals for visualization and instrumentation. Preoperative sonography is used to id...

Upper limb injuries are infrequently seen in professional football players. Common mechanisms of sustaining these injuries include 1) fall on the hyperabducted upper limb, 2) fall on the side of the shoulder 3) fall on the outstretched hand, and 4) sudden wrist dorsiflexion. Common shoulder injuries encountered in our practice include shoulder disl...

Chronic painful snapping scapula is characterized by inflammation and scarring of 1 or more bursae in the infraserratus space and is often refractory to conservative treatment. Surgical treatment involves excision of the bursae, as well as partial scapulectomy of the superomedial impinging region; both open and endoscopic approaches have been descr...

Intraosseous ganglion cysts (IOGs) are uncommon lesions of the carpal bones and can present with persistent pain and stiffness of the wrist. Surgical decompression is recommended, and a variety of approaches to decompress symptomatic IOGs of the wrist have been described. We describe an arthroscopic approach that can be performed with only 2 portal...

The arthroscopic remplissage procedure is an effective addition to a standard anterior repair in traumatic anterior shoulder instability associated with large humeral defects. The double-barrel remplissage is an all–intra-articular technique that uses a double-pulley, sliding, and self-retaining knot mechanism called the double-barrel knot. A 70° a...

Anterior shoulder instability associated with significant bone loss has been described as "bony-instability," and this condition is usually treated with an anterior glenoid bone grafting procedure (Latarjet procedure). The Latarjet procedure involves transfer of the horizontal limb of the coracoid process along with the conjoint tendon to the anter...

Distal clavicle fractures associated with coracoclavicular ligament disruption are potentially unstable and necessitate surgical treatment. Current fixation techniques are nonanatomic and do not address relevant aspects of the pathoanatomy. We have developed a technique that uses a unique combination of implants; this permits minimally invasive fix...

The double-barrel knot is a new arthroscopic sliding knot for soft tissue reconstruction and repair procedures in arthroscopic and open shoulder surgery. The double-barrel knot is a modified sliding hitch, and is formed using 2 sutures from a single double-loaded anchor (single-pulley technique) or 2 sutures from 2 adjacent anchors (double-pulley t...

Surgically repaired rotator cuff repairs may re-tear in the post-operative follow-up phase, and periodic imaging is useful for early detection. The authors describe a simple surgical technique that provides a visible clue to the tendon edge on an anteroposterior radiograph of the shoulder. The technique involves arthroscopic or mini-open radio-opaq...

Arthroscopic posterior labral repair and capsular shift procedures are technically difficult in the beach-chair position as compared with the lateral decubitus position. Optimal visualization in the beach-chair position, and anchor placement in the posterior glenoid rim, necessitate various lateral trans-cuff portals, and these may result in damage...

"Popeye biceps" deformity represents the appearance of a distally retracted biceps muscle resulting from either a traumatic long biceps tendon (LBT) rupture or an iatrogenic LBT tenotomy. Cosmetic and functional problems associated with the deformity may necessitate surgical correction, and surgical exposure using multiple incisions is recommended....

Purpose Combined occurrence of humeral avulsion of glenohumeral ligament (HAGL) lesion and a significant glenoid bone defect is an unusual and previously undescribed association in traumatic anterior shoulder instability. The purpose of this study was (1) to report a retrospective case series of seven anterior bony instability patients who were dia...

Radiographic visualization of coracoid process fractures is difficult due to the complex and variable three dimensional orientation of coracoid pillars.Failure to suspect an injury on preliminary radiographs has been described as a major reason for suboptimal management of these fractures. We describe a standardized method of patient positioning an...

Purpose: Distal clavicle fracture associated with complete coracoclavicular ligament disruption represents an unstable injury, and osteosynthesis is recommended. This study was performed (1) to retrospectively analyse the clinico-radiological outcomes of two internal fixation techniques, and (2) to identify and analyse radiographic fracture patter...

Combined bankart lesion and humeral avulsion of glenohumeral ligament lesion (HAGL) is a well-described pathologic complex in anterior shoulder instability; open surgical approaches with and without arthroscopic assistance have been suggested for simultaneous 1-stage repair of these lesions. Presence of a significant glenoid bone defect (inverted-p...

Coracoid process fractures that involve the coracoid base (inferior pillar) without a concomitant rupture of the coracoclavicular ligaments can destabilize the acromioclavicular joint with its subsequent dislocation; prophylactic or therapeutic operative treatment involving open reduction and internal fixation has been traditionally recommended. Th...

Sprengel's deformity or congenital elevation of scapula is a complex deformity of the pectoral girdle, and results in symptomatic cosmetic and functional disability. Several studies have attempted to analyze the three-dimensional aspects of this deformity; optimal methodologies of quantification and surgical correction techniques have been debated...

Anterior shoulder instability is a complex problem and necessitates accurate pre- and intraoperative assessment of soft-tissue and bony pathology. Soft tissue pathology plays a major role in anterior instability without bone loss, and includes glenoid lesions (glenoid labral tears/avulsions), capsular lesions (plastic deformation and tears), and hu...

The purpose of this study was to analyse the intermediate-term results of an arthroscopic procedure to debride and resurface the arthritic glenoid, in a middle-aged population, using an acellular human dermal scaffold. Between 2003 and 2005, thirty-two consecutive patients underwent an arthroscopic debridement and biological glenoid resurfacing for...

Chondrolabral lesions are uncommon after anteroinferior glenohumeral dislocations. This report describes a new dual-lesion complex that involved an avulsion of the anteroinferior glenoid labrum and a flap tear of the adjacent articular cartilage [glenoid labral tear and articular cartilage flap (GLAF) lesion]. The chondral component involved a larg...

Distal clavicle fractures associated with coracoclavicular ligament disruption are potentially unstable1. Internal fixation of these fractures is often inadequate due to two anatomical problems: Inadequate distal fragment size and Displacement and instability consequent to ligament disruption. We hypothesize that a contour-matched locking plate c...

Anterior approaches to the shoulder involve partial or complete detachment of the subscapularis muscle. We have developed a new technique that permits adequate access to the humeral attachment of the inferior glenohumeral ligament (IGHL) without any detachment of the subscapularis, and have used this to successfully repair humeral avulsions of glen...