Arthroscopic technique for distal tibial allograft bone augmentation with suture anchor fixation for anterior shoulder instability

John M. Tokish, M.D., an orthopedic surgeon at Mayo Clinic's campus in Arizona, initiates diagnostic arthroscopy to assess pathology and then obtains preoperative imaging. Dr. Tokish prepares the glenoid surface for graft placement, creating a flush surface to receive the graft. He prefers a tibial allograft and soaks the graft with platelet-rich plasma. He places a Latarjet guide until the flange sits flush on the glenoid. He then places Kirschner wires and overdrills to create tunnels for fixation. Through these tunnels, he places an arthroscopic router that can prepare the surface of the bone. To offset the patient's bone loss, he places 8 to 12 millimeters of graft arthroscopically and can visualize an exact match to the glenoid surface. The graft is secured without metal implants and with greatly decreased risk of neurovascular complications.


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March 15, 2022

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Mayo Clinic

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John Tokish, MD

John Tokish, MD

Orthopedic Surgeon

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