Arthroscopic Trillat With Pan Capsulorrhaphy for Management of Shoulder Instability Secondary to Ligamentous Laxity: A Technique Guide

The Trillat procedure was developed for the management of anteroinferior (AI) instability in patients with irreparable cuff tears and those with shoulder hyperlaxity with no glenohumeral bone loss. The latter patient group has traditionally been managed nonoperatively first, with surgical intervention only in those with unsuccessful conservative care with significant impediments to their function. Although many procedures have been described to correct this instability, we believe that a combination of coracoid osteotomy and its medial-inferior shift to provide a sling effect via the conjoint tendon and obliteration of the subcoracoid space, as well as a pan-capsular shift to reduce the glenohumeral volume addresses this instability. Our all-arthroscopic technique is minimally invasive, using just 3 portals, and provides access to other articular pathology.