Practising on models
A practice session using Arthrex shoulder models, supported by Device Technology. Fellows Bart Jan Veen and Andrew Ker worked through arthroscopic stabilisation procedures, concentrating on anterior and posterior shoulder stabilisation. Research assistant Brandon Ziegenfuss also took part.
Why model work matters
Arthroscopic surgery is performed looking at a screen while manipulating instruments through small portals, which is a skill that has to be built up separately from open surgical technique. Model sessions allow the sequence and the hand movements to be rehearsed repeatedly, which is not something that can be done on an operating list.
With thanks to Device Technology for their support.
Anterior and posterior stabilisation
The shoulder is a shallow ball and socket joint, and what depth it has comes largely from the labrum, a rim of soft tissue around the edge of the socket, together with the capsule and ligaments surrounding the joint. When the shoulder dislocates those structures are damaged, and the joint can then slip out of position repeatedly.
Anterior instability, where the joint slips forward, is the more common pattern and usually follows a dislocation. Posterior instability, where it slips backwards, is less common, is often not the result of a single injury, and is more easily missed. An arthroscopic stabilisation repairs the labrum and tightens the capsule back onto the rim of the socket using anchors placed in bone. Where bone has been lost from the socket, or a repair has already failed, a bone transfer such as a Latarjet may be considered instead. Individual results vary.
The two repairs are performed from different angles, with the camera and instruments in different portals, and a practice session therefore works through them separately rather than treating them as one procedure.
What a model session allows
- A step can be repeated until the movement is reliable, then interrupted and discussed.
- Portal placement can be tried and reconsidered without consequence.
- The implants and instruments are the ones used in theatre, so the handling is familiar.
- Two fellows can work through the same procedure and compare how they approached it.
Related information
See our shoulder instability page, along with our anterior instability, stabilisation, arthroscopic Bankart repair and shoulder fellowship pages.