Paper 03: The Anterior Labral Circumferential Onlay Technique (ALCOT) serves to reconstruct the anterior labrum and biomechanically restores anterior glenohumeral joint stability

Objectives: The standard of care for treating anterior shoulder instability caused by a labral detachment is the Bankart repair. In case deficient labrum with significant antero-inferior glenoid bone loss, latarjet technique can be used instead. However, when and loss minimal, reconstruction has been recently proposed as an alternative. A new called Anterior Labral Circumferential Onlay Technique (ALCOT) was developed, which reconstructs using long head biceps tendon. purpose this study to biomechanically evaluate efficacy ALCOT stabilize joint against dislocation in setting no loss. Methods: Ten fresh-frozen cadaveric shoulders were tested 5 consecutive states 6-degrees-of-freedom robotic arm: (1) Native, (2) Capsular Repair, (3) Tear (4) (5) Latarjet. capsule repair state control because needed opened repaired perform other states. This ensured that any differences due surgical procedure being tested, not iatrogenic damage capsule. performed detaching from between 3-6 o’clock removing it joint. For ALCOT, tendon shortened at distal portion pulled into Three knotless all suture anchors placed 3, 4:30 6 position on rim, secured mattress stitches. latarjet, coracoid autograft cut 25 mm tip, keeping conjoint tendons intact, two screws. native state, each specimen underwent initial test determine appropriate amount inferior displacement future tests. test, 50N compressive load maintained while 80N force applied sagittal plane 45° angle axes. corresponding displacements recorded. Then, including native, performed. driven previously recorded positions displace lateral humeral throughout motion. Higher translation considered more stable, corresponded larger obstacle overcome during dislocation. To account variation normalized create ratio. metric accounts fact required dislocate depends stabilizing provided robot vitro, muscle tension vivo. Results: No found capsular Compared tear significantly decreased 6.5mm 5.4mm (p<0.001) ratio 1.8 1.1 (p=0.002), decrease 90N 55N load. restored these values 6.4 1.4, respectively, showing difference native. 1.3 (not native) but failed restore value 5.6 (p=0.003 different tear). shown figure 1 2. Conclusions: novel treatment option labrum. technique, involves less morbidity represents anatomic surface replacing without changing bony morphology. study, also showed superior stabilization restoring humerus translation. Further research necessary clinically validate possibly expand indications small degrees [Table: see text]