Confession Session: Iatrogenic Humeral Head Articular Cartilage Disruption During Remplissage

Description

In this segment, Jordan Buchko discusses a surgical case involving a 28-year-old female patient suffering from recurrent traumatic anterior glenohumeral instability. The case included a Bankart lesion and a significant Hill-Sachs lesion, which were confirmed via MRI. Buchko emphasizes the importance of the remplissage procedure in conjunction with an arthroscopic Bankart repair to reduce the rate of recurrence in similar cases.



However, during the surgery, Buchko experienced a significant technical error by violating the anterior humeral head cartilage while placing an anchor, leading him to reflect on the situation and outline precautions for the future.



He notes that the patient's small skeletal structure required him to exercise caution and suggests measuring the depth from the Hill-Sachs lesion to the anterior humeral head to avoid mishaps. Buchko advises on the importance of understanding the specific anchors being used, ensuring that they are deployed at the correct depth to prevent complications. He stresses the importance of checking angles during insertion and aiming more laterally to avoid medial deviation. Overall, this presentation serves as both a case study and a cautionary lesson for future surgical procedures.

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