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Dr. Garcia demonstrates his new technique for the Latarjet procedure.
Dr. Garcia specializes in complex knee, shoulder and elbow sports surgeries. He has prepared a number of surgical videos below to help patients better understand their procedures. He is frequently updating his surgical video database so check back soon for further updates.
This video features Dr. Grant Garcia demonstrating his advanced arthroscopic technique for an anterior labral (Bankart) repair paired with a Remplissage procedure to address recurrent anterior shoulder instability.
This combined approach is highly indicated for patients who exhibit both an anterior labral tear (Bankart lesion) and an engaging Hill-Sachs lesion—a divot or indentation on the back of the humeral head caused by the bone striking the edge of the socket during past dislocations.
The procedure is executed through the following key steps:
- Joint Evaluation & Bankart Mobilization: Dr. Garcia accesses the front of the shoulder joint to inspect the damage. He isolates the torn, scarred-down anterior labrum and carefully frees it from the glenoid rim using an arthroscopic elevator. He then uses a specialized rasp to lightly abrade the bone, creating a raw, bleeding footprint to optimize biological tissue-to-bone healing.
- Humeral Defect Debridement: Shifting focus to the back of the joint, Dr. Garcia visualizes the Hill-Sachs defect on the humeral head. He debrides any scar tissue or debris caught inside the crater, exposing clean bone underneath to receive the upcoming repair anchors.
- Remplissage Stitching (Filling the Defect): Suture anchors are drilled and securely seated straight into the valley of the Hill-Sachs defect. Using specialized arthroscopic suture passers, Dr. Garcia drives the anchor sutures right through the posterior joint capsule and the adjacent infraspinatus tendon. When tensioned, these sutures pull the soft tendon tissue down into the bone crater like a structural plug (tenodesis), mechanically preventing the defect from catching on the socket rim.
- Anterior Labral Reattachment: To finish the dual-reconstruction, Dr. Garcia returns to the front of the shoulder. He inserts suture anchors into the anterior glenoid rim, takes precise bites through the mobilized labral tissue, and tightens the sutures down to reconstruct a thick, robust anterior labral bumper.
The final evaluation demonstrates that the combined construct successfully fills the structural bone gap on the humerus while firmly anchoring the front of the joint. This eliminates both the physical catching mechanism and pathological forward shifting, ensuring a reliable stabilization pattern for the athlete's shoulder.
