Arthroscopic Anterior and Posterior Glenoid Bone Augmentation With Capsular Plication for Ehlers-Danlos Syndrome With Multidirectional Instability

Arthroscopic Anterior and Posterior Glenoid Bone Augmentation With Capsular Plication for Ehlers-Danlos Syndrome With Multidirectional Instability

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Recurrent multidirectional shoulder instability is a difficult clinical problem.This can be compounded in patients with connective tissue diseases such as Ehlers-Danlos syndrome.We present an all-arthroscopic technique involving extra-articular anterior and Wrist Braces posterior glenoid bone grafting to augment a capsular repair in a patient with Ehlers-Danlos syndrome and recurrent multidirectional shoulder instability.

Graft options include either distal tibial allograft or iliac crest autograft.Anterior graft placement uses a dilated far medial portal using an inside-out technique.The posterior graft is placed through a dilated posterior portal.

A 1-mm edge of anterior and posterior glenoid rim is denuded of cartilage for later capsular repair, and grafts are secured flush to the osseous surface.A capsular plication is then completed and repaired to the prepared native glenoid surface, using Anemometers the grafts as extra-articular osseous bumpers.