Editorial Commentary: Our Mentors Were Right, New Is Not Always Better: The Posterolateral Shoulder Trans-Rotator Cuff Portal Is Safe for SLAP Repairs

Abstract

Shoulder SLAP repair anchors have traditionally been placed through a posterolateral trans-rotator cuff “Port of Wilmington” portal. Alternative anterolateral portals have been proposed to place superior glenoid anchors that seemingly avoid traversing the rotator cuff via the rotator interval but put the suprascapular nerve at risk. A recent cadaveric study demonstrated that the traditional posterolateral portal safely traversed the infraspinatus muscle belly in all specimens, which was in contrast to the anterolateral portal that traversed the supraspinatus tendon in all specimens. In addition, 80% of anchors placed through the anterolateral portal perforated the posterior glenoid in proximity to the suprascapular nerve. As originally suggested nearly 20 years ago, the posterolateral Port of Wilmington trajectory is safe on both the rotator cuff and glenoid side for SLAP repairs.