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Arthroscopic Trillat Procedure: A Guided Technique

The Trillat procedure is a surgical treatment for recurrent anterior shoulder instability in the setting of significant or irreparable rotator cuff tears in elderly patients. The procedure comprises an inferior closing wedge partial osteotomy of the coracoid process with fixation to the glenoid neck...

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Detalles Bibliográficos
Autores principales: Swan, John, Boileau, Pascal, Barth, Johannes
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7189268/
https://www.ncbi.nlm.nih.gov/pubmed/32368472
http://dx.doi.org/10.1016/j.eats.2019.12.004
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author Swan, John
Boileau, Pascal
Barth, Johannes
author_facet Swan, John
Boileau, Pascal
Barth, Johannes
author_sort Swan, John
collection PubMed
description The Trillat procedure is a surgical treatment for recurrent anterior shoulder instability in the setting of significant or irreparable rotator cuff tears in elderly patients. The procedure comprises an inferior closing wedge partial osteotomy of the coracoid process with fixation to the glenoid neck. This results in a lowered and medialized coracoid process that acts as a bone block and the conjoint tendon is brought closer to the glenohumeral joint, thus closing the subcoracoid space, which blocks humeral dislocation. We describe an arthroscopic step-by-step guided Trillat technique that is simple, efficient, and reproducible, while minimizing risk in the extra-articular subcoracoid space. Our technique does not require the release of the pectoralis minor tendon from the coracoid process, which reduces the risk of damaging the brachial plexus. We use a tight-rope fixation construct that allows progressive transfer of the coracoid process, limiting fracture risk and the risk of overtightening of the subscapularis muscle. Because there is a trend for more complex procedures being performed arthroscopically, it is important to develop and simplify operative techniques, aiding surgeons in achieving reproducible and reliable patient outcomes.
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spelling pubmed-71892682020-05-04 Arthroscopic Trillat Procedure: A Guided Technique Swan, John Boileau, Pascal Barth, Johannes Arthrosc Tech Technical Note The Trillat procedure is a surgical treatment for recurrent anterior shoulder instability in the setting of significant or irreparable rotator cuff tears in elderly patients. The procedure comprises an inferior closing wedge partial osteotomy of the coracoid process with fixation to the glenoid neck. This results in a lowered and medialized coracoid process that acts as a bone block and the conjoint tendon is brought closer to the glenohumeral joint, thus closing the subcoracoid space, which blocks humeral dislocation. We describe an arthroscopic step-by-step guided Trillat technique that is simple, efficient, and reproducible, while minimizing risk in the extra-articular subcoracoid space. Our technique does not require the release of the pectoralis minor tendon from the coracoid process, which reduces the risk of damaging the brachial plexus. We use a tight-rope fixation construct that allows progressive transfer of the coracoid process, limiting fracture risk and the risk of overtightening of the subscapularis muscle. Because there is a trend for more complex procedures being performed arthroscopically, it is important to develop and simplify operative techniques, aiding surgeons in achieving reproducible and reliable patient outcomes. Elsevier 2020-04-23 /pmc/articles/PMC7189268/ /pubmed/32368472 http://dx.doi.org/10.1016/j.eats.2019.12.004 Text en © 2020 Published by Elsevier on behalf of the Arthroscopy Association of North America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Technical Note
Swan, John
Boileau, Pascal
Barth, Johannes
Arthroscopic Trillat Procedure: A Guided Technique
title Arthroscopic Trillat Procedure: A Guided Technique
title_full Arthroscopic Trillat Procedure: A Guided Technique
title_fullStr Arthroscopic Trillat Procedure: A Guided Technique
title_full_unstemmed Arthroscopic Trillat Procedure: A Guided Technique
title_short Arthroscopic Trillat Procedure: A Guided Technique
title_sort arthroscopic trillat procedure: a guided technique
topic Technical Note
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7189268/
https://www.ncbi.nlm.nih.gov/pubmed/32368472
http://dx.doi.org/10.1016/j.eats.2019.12.004
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