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The novel coronavirus first emerged in Wuhan, People's Republic of China, in December 2019. The subsequent unprecedented spread has since led to the global COVID-19 (the disease caused by the virus) pandemic, which was declared a public health emergency by the World Health Organization on January 30, 2020 1. As of April 1, 2020, a total of 754,948 cases have been reported globally, with 36,571 confirmed deaths 2. Singapore was one of the first other countries to be affected, and up until February 19, 2020, had the highest number of COVID-19 cases apart from the People's Republic of China 3. Despite being the earliest other country affected, the initial containment strategies in Singapore have been largely successful in achieving a relatively low case-fatality rate (0.3%) compared with that of Italy (7.7%) 4,5. Although we continue to adapt to the evolving situation, we believe that our experience in Singapore thus far may provide valuable insights into the challenges and strategies of orthopaedic and specifically spine surgery in the COVID-19 climate. Response in Singapore: A Look from the Front Lines Unique to our institution at Tan Tock Seng Hospital, we are at the epicenter of the COVID-19 outbreak in Singapore, being connected to the National Centre of Infectious Diseases (NCID), a specialist facility for the management of infectious diseases. The NCID comprises isolation and intensive-care wards, operating theaters, radiology and laboratory facilities, Disclosure: The authors indicated that no external funding was received for any aspect of this work. The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJS/F854).

Surgical treatment of anterior glenohumeral joint instability can be challenging and carries the inherent risk of recurrent instability, dislocation arthropathy, and postoperative loss of external rotation. In the current manuscript, a technique for combined reconstruction of anterior labrum and capsule, with concomitant reduction of the humeral head during anterior capsule reconstruction in open Latarjet procedure, is presented. Analogous to other techniques, the coracoid graft is fixed on the anteroinferior part of the glenoid between 3 and 5 o'clock. However, for this technique, reattachment of the labrum is performed between the native glenoid and the bone graft. Additionally, during the reconstruction of the anterior capsule on the coracoacromial ligament, while the operated arm is held in external rotation to avoid the postoperative rotational deficit, the humeral head is reduced posteriorly in the center of the glenoid during adduction, slight anterior forward flexion, and a posterior lever push. By doing so, the inherent theoretical risks of persistent instability and dislocation arthropathy are believed to be decreased. Further studies are needed to clarify the long-term consequences of this surgical technique in the clinical setting.

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