IV-Retrospective study.

Among the many different procedures available in the treatment of shoulder instability, the Trillat procedure remains indicated in case of recurrent shoulder instability in elderly patient with an irreparable cuff tear or in case of hyperlaxity. Despite the constantly increasing number of arthroscopic assisted techniques, the open procedure remains a simple, reliable and fast surgical procedure with a shorter learning curve than the arthroscopic techniques. It consists in a partial osteotomy of the anterior cortical of the coracoid process which is then tilted and fixed with a screw into the anterior part of the scapula downwards and medially to obtain a re-centering effect due to the conjoint tendon on the humeral head when rotational movement are applied. This article aims to present a stepwise approach for the open surgical technique.

Pathology of the long head of the biceps can contribute to substantial shoulder pain. After nonoperative treatment has failed, either open or arthroscopic tenotomy or tenodesis can be recommended depending on age, occupation, function, and cosmetic preference. While classic tenodesis techniques rely on tendon-to-bone fixation, multiple studies have shown superior healing results for fixation between similar types of tissue, such as tendon-to-tendon. In this technique, we present the "sandwich technique," performed entirely arthroscopically. A single 4-strand anchor with bioabsorbable screw is used to provide 2 types of fixation. Two strands are first used to lasso-loop the long head of the biceps to the bicipital groove, providing bone-to-tendon fixation. The other strands are then used to anchor rotator interval tissue to the tendon, providing a similar tissue or tendon-to-tendon patch augmentation.

A distally based sartorius muscle flap may be a suitable alternative for coverage of complex soft-tissue defects around the knee joint.