title: Quantitative and Computed Tomography Anatomic Analysis of Glenoid Fixation for Superior Capsule Reconstruction: A Cadaveric Study.
abstract: OBJECTIVE
  To investigate glenoid fixation for superior capsule reconstruction (SCR) and evaluate anchor positions, intraosseous trajectories, and proximity to the suprascapular nerve (SSN) and glenoid fossa. The secondary purpose was to provide technical pearls and pitfalls for anchor insertion on the superior glenoid during SCR.
  
  
  METHODS
  Three beath pins were arthroscopically inserted into 12 (n = 12) nonpaired human cadaveric shoulders through Neviaser, anterior, and posterior portals to simulate anchor placement on the superior glenoid during SCR. Computed tomography scans were performed to evaluate anchor positioning and insertion trajectories. Specimens were then dissected to delineate the anatomic relations of the beath pins to the SSN and glenoid fossa.
  
  
  RESULTS
  The superior glenoid anchor position was a mean 15.0 ± 4.0 mm to the SSN and 6.5 ± 1.7 mm to the glenoid fossa. The posterior glenoid anchor position was a mean 11.8 ± 2.1 mm to the SSN and 2.9 ± 2.9 mm to the glenoid fossa. On average, the superior pin was placed at 12:30 ± 0:30 (left-sided glenoid clock face) and inserted at 19° ± 9° with respect to the sagittal plane of the glenoid, the anterior pin was placed at 11:00 ± 0:30 and inserted 40° ± 17° off the glenoid, and the posterior pin was placed at 3:00 ± 1:00 and inserted at 52° ± 12° off the glenoid.
  
  
  CONCLUSIONS
  The results of the present cadaveric study showed that glenoid fixation was safe with respect to the SSN and delineated technical guidelines and trajectories for inserting 3 anchors into the glenoid.
  
  
  CONCLUSIONS
  This study shows that 3 anchors can be inserted into the glenoid without a risk of SSN damage and delineates technical guidelines for anchor insertion.
authors.affiliation: Department of BioMedical Engineering, Steadman Philippon Research Institute, Vail, Colorado, U.S.A.
authors.forename: Jason M
authors.initials: JM
authors.lastname: Schon
authors.affiliation: Department of BioMedical Engineering, Steadman Philippon Research Institute, Vail, Colorado, U.S.A.; Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Münster, Germany.
authors.forename: J Christoph
authors.initials: JC
authors.lastname: Katthagen
authors.affiliation: Department of BioMedical Engineering, Steadman Philippon Research Institute, Vail, Colorado, U.S.A.
authors.forename: Cameron N
authors.initials: CN
authors.lastname: Dupre
authors.affiliation: Department of BioMedical Engineering, Steadman Philippon Research Institute, Vail, Colorado, U.S.A.
authors.forename: Justin J
authors.initials: JJ
authors.lastname: Mitchell
authors.affiliation: Department of BioMedical Engineering, Steadman Philippon Research Institute, Vail, Colorado, U.S.A.
authors.forename: Travis Lee
authors.initials: TL
authors.lastname: Turnbull
authors.affiliation: Naples Physicians Groups, Naples, Florida, U.S.A.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Adams
authors.affiliation: Southern Oregon Orthopedics, Medford, Oregon, U.S.A.
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Denard
authors.affiliation: Department of BioMedical Engineering, Steadman Philippon Research Institute, Vail, Colorado, U.S.A.; The Steadman Clinic, Vail, Colorado, U.S.A.. Electronic address: drmillett@thesteadmanclinic.com.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Millett
mesh_terms: D000328:Adult; D000368:Aged; D001182:Arthroscopy; D001858:Bone Nails; D002102:Cadaver; D005260:Female; D061165:Glenoid Cavity / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012540:Scapula / Q000000981:diagnostic imaging / Q000294:innervation / Q000601:surgery*; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed