Tensionable lesser tuberosity osteotomy repair for anatomic total shoulder arthroplasty

• Published in: JSES reviews, reports, and techniques Vol. 4; no. 3; pp. 600 - 606
• Main Authors: Cohn, Matthew R., Baker, William, Schiffman, Corey J., Vadhera, Amar S., Bustamante, Sebastian, Austin, Luke S.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Inc 01.08.2024; Elsevier
• Subjects: Anatomic total shoulder arthroplasty; Lesser tuberosity osteotomy; Shoulder arthroplasty; Shoulder replacement; Subscapularis repair; Technique; Anatomic total shoulder arthroplasty; Technical Note; Subscapularis repair; Shoulder replacement; Shoulder arthroplasty; Lesser tuberosity osteotomy; Technique
• ISSN: 2666-6391; 2666-6391
• DOI: 10.1016/j.xrrt.2023.09.014

A lesser tuberosity osteotomy (LTO) is commonly performed during total shoulder arthroplasty to access the glenohumeral joint. Healing of the LTO is critical to optimizing the outcome of the procedure and is enhanced by a repair that provides stability and compression across the osteotomy site. The purpose of this article is to describe a technique that uses a tensionable suture construct to repair the LTO during anatomic total shoulder arthroplasty using a stemless humeral component. The technique involves passing a row of high-tensile sutures through bone tunnels lateral to the osteotomy site (transosseous sutures) and another row of sutures through the humeral implant (implant sutures). One limb of each bone tunnel suture is then tied to its corresponding limb of implant suture and the remaining free strands of the tied sutures are manually tensioned and tied to each other. This technique is an efficient and reproducible method for creating compression and stability across the osteotomy site that facilitates bony healing.