Infraspinatus Tenotomy Improves Glenoid Visualization With the Modified Judet Approach

Objectives: To determine if the addition of an infraspinatus tenotomy to the modified Judet approach (MJA) improves glenoid visualization. Methods: 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. Results: Adding an infraspinatus tenotomy to the MJA significantly increased total glenoid area (cm 2 ) 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. Conclusions: 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.