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Background: The inferior glenohumeral ligament (IGHL) comprising the anterior and posterior bands with interposing axillary pouch is an important static stabilizer of anterior translation and external rotation (ER) in the 90-degree abduction position. No literature is available to determine any ideal graft or isometric point for fixation of any graft to replace the functionality of IGHL such that the tensile stress acting on the graft is under the limits of the tensile properties of the graft used for reconstruction., Methods: Using finite element method analysis (FEM) of the long head of the biceps tendon (LHBT) with modeling and simulation process, the ultimate tensile strength of the LHBT at the different clock positions of the humeral head attachment and angular positions of the humerus were determined through a combination of Taguchi Design of Experiments and simulation using ANSYS (Analysis system) software., Results: Through FEM simulations using the ANSYS software, it was concluded that the clock position of 7:30 would be appropriate to fix the biceps Tendon on the humerus. The tensile stress induced in the IGHL at 7:30 on the humerus, at 90° abduction with 90° rotation of the humerus, as well as at 120° abduction with 90° rotation of the humerus was evaluated and validated., Conclusions: Reconstruction of anterior band of IGHL using LHBT in its isometric points found in this study can provide a solution to manage anterior instability anatomically rather than non-anatomical procedures like dynamic anterior stabilization. This will be an anatomical procedure that will bridge the gap between anatomical Bankarts procedure and non-anatomical latarjet procedure. The LHBT can be suitable graft material for the anterior band of the IGHL reconstruction. Our study demonstrated that the most optimal fixation points for the graft, which resulted in the least tensile stress on the LHBT, were found to be at the 3 o'clock position on the glenoid and the 7:30 o'clock position on the humerus., Level of Evidence: LEVEL 5 - methodological verification and validation., Competing Interests: Declaration of competing interest None declared., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

In this case report, a unique instance of delayed isolated anterior branch axillary nerve injury following shoulder dislocation is highlighted. The patient, a 55-year-old manual laborer, presented with severe deltoid wasting and reduced power 18 months postdislocation, necessitating a specialized treatment approach. The use of axillary nerve neurolysis and an innovative upper trapezius to anterior deltoid transfer via a subacromial path posterior to the clavicle, facilitated by an autologous semitendinosus graft, resulted in significant improvement with 160 degrees of abduction and Grade 4+ power Medical Research Council grading (MRC) at the 5-year follow-up., Competing Interests: Declaration of competing interest The authors declare that no financial interests/personal relationships exist to be considered as potential competing interests., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Partial articular supraspinatus tendon avulsion (PASTA) lesions, a subset of partial rotator cuff tears, pose a surgical challenge, disrupting the integrity of the supraspinatus tendon. Transtendinous repair is the preferred choice in young individuals for limiting tear progression and preserving intact, high-quality cuff tissue, thus preventing tendon shortening, as compared to the tear completion and repair technique. Our approach leverages these advantages, specifically those indicated for Ellman's Grade 3 tears and cases where conservative treatments have failed. In our technique, we employ progressive dilation, anchor drill sleeve insertion to facilitate medial row anchor placement, followed by percutaneous spinal needles for suture shuttling, and finally locking sliding knots for compressive medial row repair, followed by lateral row fixation for additional stability. This method accelerates rehabilitation and restores optimal shoulder function., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)