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ARTHROSCOPIC LATARJET PROCEDURE (First Anthroscopy in Karnataka)

  • Shoulder is a ball and socket joint, which can dislocate with extreme range activities. The younger the patient the more chances of repeat dislocation.
  • With a dislocation the stabilizing ligaments around the shoulder tear away from their position. Treatment of this condition is by Arthroscopy( key hole ) surgery of the shoulder by which a small camera( scope) is passed into the shoulder , the ligaments are visualized and repaired. This is the most commonly done surgery called ARTHROSCOPIC BANKART REPAIR.
  • But with multiple dislocations (neglected conditions), there is significant bone loss in the socket part of the joint DUE TO REPEATED DENTING and requires additional bone filling of the defect in the socket.
  • This process of filling the defect in the socket is called as a bone block procedure ( latarjet procedure). Here a piece of bone called the coracoid process which is next to the joint is cut, rotated and fixed on to the side of the socket.
  • This bone block technique was done as an open procedure, with an extensile surgical incision, till date in most centers in the world.
  • Arthroscopic (key hole) Latarjet gives excellent precision in positioning the bone block with just 4 key holes in the shoulder, with lesser bleeding and complications. But this is technically demanding and done by only a few surgeons worldwide and in India.
  • Dr. Ayyappan V Nair is one of the few surgeons in the country to do the procedure. He has received the trainings from some renowned  institutions across the world like Funabashi orthopaedic center in japan, Hallym university in S.Korea, Subiaco clinic- Australia, Spain and the United states.

ARTHROSCOPIC SUPERIOR CAPSULAR RECONSTRUCTION USING FASCIA LATA GRAFT

  • The main lifter of the shoulder joint is called the rotator cuff which is group of 4 muscles arranged from front to back of the shoulder. Rotator cuff can tear due to degeneration- wear and tear / trauma- fall.
  • Usually its repaired by a procedure called arthroscopic rotator cuff repair, but in neglected cases the cuff muscles will be deficient and it is impossible to repair the tissue.
  • The options after this is limited, and usual answer to this is irreparable tear is to do a reverse shoulder arthroplasty(shoulder replacement).
  • Dr. Ayyappan V Nair has received training from Dr.Mihata the architect of SCR, and regularly does superior capsular reconstruction, where a muscle graft from the thigh is used to augment the defective tear giving excellent results in 3 months.

REVERSE SHOULDER ANTHROPLASTY(REPLACEMENT)

  • Unit- MHW – 1 ST TIME
  • REGULAR PROCEDURE BUT RARE COMPARED TO KNEE REPLACEMENT
  • IN A SEVERLY ARTHRITIC SHOULDER, WITH ABSENT MUSCLES (ROTATOR CUFF) THE BONE SURFACES ARE REPLACED, BUT IN A REVERSED FASHION.
  • THIS IS THE ONLY SALVAGE PROCEDURE IN A BADLY DAMAGED SHOULDER.
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