The “Mooring” Technique for Large Anterior Glenoid Rim Fractures Results in Favorable Clinical and Radiological Outcomes

PURPOSE: To describe the arthroscopic "mooring" technique for the treatment of large anterior glenoid rim fractures and report the clinical and radiological outcomes of a consecutive case series treated with this technique. METHODS: This retrospective study was conducted between January 2016 and August 2023. Eligible patients were those with acute anterior glenoid rim fracture (≥20% glenoid width involvement, displacement >5 mm) who underwent the "mooring" technique. All completed preoperative, 1-day postoperative, and 6-month postoperative computed tomography scans, as well as radiographs and clinical follow-up for a minimum of 2 years. Clinical outcomes were assessed using the American Shoulder and Elbow Surgeons score, Constant-Murley score, Rowe score, the Single Assessment Numeric Evaluation, and visual analog scale for pain. Radiographic parameters included reduction quality, bone union, and glenohumeral osteoarthritis progression. RESULTS: A total of 56 patients was included in the final analysis (40 men, 16 women; mean age, 46.8 ± 16.2 years). The mean follow-up period was 27.2 ± 2.9 months. At the final follow-up, the mean American Shoulder and Elbow Surgeons, Constant-Murley, Rowe scores, Single Assessment Numeric Evaluation, and visual analog scale for pain were 89.5 ± 6.4, 90.3 ± 6.0, 89.6 ± 4.5, 83.2 ± 8.5, and 1.1 ± 1.0 points, respectively. Range of motion of the affected shoulder differed from the contralateral side: anterior flexion deficit -8° (P < .001), external rotation deficit -6° (P < .001), and internal rotation (P < .001). Bone union rate was 100% at 6 months postoperatively (66.1% complete, 33.9% partial). Satisfactory reduction quality (grade I/II) was achieved in 52 (92.9%) cases. Four patients (7.1%) showed glenohumeral osteoarthritis progression at the final follow-up. CONCLUSIONS: The arthroscopic "mooring" technique for large anterior glenoid rim fractures yields satisfactory 2-year short-term outcomes, featuring favorable reduction quality, a high bone union rate, and good clinical functional recovery. LEVEL OF EVIDENCE: Level IV, retrospective case series.