Comparison of Curved and Straight Anchor Insertion for SLAP Repair: A Cadaveric Study

Editorial Commentary: All-Suture Shoulder Glenoid Anchors: Can We Adequately Tension Them or Knot?

“…9,10 Curved drill guides are proposed to mitigate this concern. Grieshober et al 11 evaluated curved and straight JuggerKnot 1.5 drill guides in human cadaveric shoulders. Using an anterolateral transrotator cuff portal all-suture anchor placement at the posterior and far posterior positions (11 and 10 o'clock in a right shoulder) resulted in complete glenoid perforation in 30% of curved drill guides and 60% of straight drill guides.…”

“…Importantly, 72% of these penetrations hit the suprascapular nerve. 11 The axillary nerve lies 10 mm from the inferior glenoid at the 6 o'clock position. Many surgeons advocate placing an anchor at this low position.…”

Editorial Commentary: SLAP Repair—The Anterosuperior Portal for Anchor Placement Is Best

“…I t was with great interest that we read "Comparison of Curved and Straight Anchor Insertion for SLAP Repair: A Cadaveric Study" by Grieshober, Palmer, Kim, Jaffe, Paryavi, Hasan, and Henn. 1 They performed a cadaveric anatomic and biomechanical study to assess the safety and strength of using the anterolateral portal for posterior anchor placement for SLAP repairs. The study was extraordinarily well performed, and we commend the authors for their work in trying to enhance the safety of anchor placement in the glenoid.…”

“…Grieshober et al 1 cited the work of Sando et al 2 showing that the anterolateral portal often traverses the supraspinatus tendon. Other authors have advocated a percutaneous posterior portal for anchor placement.…”

“…Grieshober et al 1 did not mention the trajectory of the drill guides and only mentioned that they were placing posterior and far-posterior anchors. When placing the drill guide at the intended anchor position, it is essential to aim toward the center of the glenoid to avoid medial perforation and contact with the suprascapular nerve.…”