To determine if the addition of an infraspinatus tenotomy to the modified Judet approach (MJA) improves glenoid visualization.
We performed an MJA on 14 human cadaveric shoulders. After exposing the glenoid, the boundary of the visualized glenoid surface was marked with a 1.8- and 2.0-mm drill bit before and after performing an infraspinatus tenotomy, respectively. The humerus was disarticulated, and the pre- and post-tenotomy drill marks were verified. The area of the entire glenoid, and each of the 4 quadrants [anterior-superior (AS), anterior-inferior (AI), posterior-superior (PS), and posterior-inferior (PI)] were analyzed using a custom image-processing program. The amount of glenoid exposure and percentage of area visualized before and after the tenotomy were compared.
Adding an infraspinatus tenotomy to the MJA significantly increased total glenoid area (cm2) exposure by 33%, P < 0.0001. Three of 4 glenoid quadrants (PS, AS, and AI) had a significant increase in glenoid visualization, with the AS quadrant having the most substantial improvement after the tenotomy (+67%), P < 0.0001.
The results provide the percentage of glenoid fossa that can be seen using an MJA and demonstrate that visualization significantly improves after adding an infraspinatus tenotomy.