Chapter 3 Instability
CHAPTER 3 | Instability
Postoperative Rehabilitation The patient uses a sling for 6 weeks, with external rota- tion restricted to 0°. After 6 weeks, the sling is discon- tinued, and overhead motion is encouraged. Gentle external rotation stretching is begun at 6 weeks post- operative, with the goal that at 3 months postoperative,
For the glenoid side, we use a 70° angled sawblade to create a flat recipient surface on the anterior glenoid neck (Fig. 3-16A). We believe that it is important to match these two flat surfaces exactly, and the 70° sawblade gives the perfect orientation for a flush fit of the two bone surfaces (Fig. 3-16B–E).
FIGURE 3-16 Schematic showing the use of the 70° angled sawblade to prepare a flat recipient surface on the anterior glenoid neck. A: A 70° angled sawblade. B: The plane of the eroded anterior glenoid is not optimal to receive the coracoid graft at an angle that will produce a smooth articular arc between the glenoid concavity and the concavity of the graft. C: The 70° angle of the sawblade allows the surgeon to approach the anterior glenoid at a comfortable working angle to make a flat cut that is approximately in line with the axis of the scapula. D: Flat saw-cut has been completed on the anterior glenoid neck. E: Fixation of the coracoid to the glenoid neck is optimized by the perfect orientation of the two flat saw-cuts.
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