Labral Repair of the Acetabulum Using a Toggle Suture Technique

Figures

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  Fig 1. (A) Arthroscopic view of the anterior-superior labrum of a right hip with the patient in the supine position. A Labral Scorpion passes a “0” gauge FiberWire suture that has been folded in half at the chondrolabral junction. (B) External view showing the camera in the anterolateral portal and a slotted cannula and Labral Scorpion in the midanterior portal. The slotted cannula retracts the proximal capsule to help visualize the acetabular rim. (C) Left hip model view showing the folded suture passed at the chondrolabral junction.

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  Fig 2. (A) Arthroscopic view showing the passed suture retrieved through the midanterior portal. (B) External view showing the suture loop pulled out of the midanterior portal. The surgeon uses one hand to open the loop and the other hand to hold the free tails. (C) Left hip model view showing the orientation of the passed suture loop and free tails.

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  Fig 3. (A) Arthroscopic view showing the passed suture retrieved through the midanterior portal. (B) External view showing the surgeon pulling 1 free tail of the suture through the loop to create the toggle suture. (C) Left hip model showing 1 free suture tail passed through the loop.

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  Fig 4. (A) Arthroscopic view showing initial placement of the toggle suture. Note that the suture tails are positioned on either side of the labrum. The “hitch” or crossover area of the suture is positioned on the backside of the labrum. The gross rotation of the labrum is adjusted before initial anchor placement. (B) External view showing independent tensioning of the suture tails to optimize rotational position of the labrum. (C) Left hip model showing the suture looped around the labrum with a tail on each side.

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  Fig 5. (A) Arthroscopic view of the repositioned labrum after it is secured with a 2.4-mm PEEK PushLock suture anchor. (B) Left hip model view showing final suture orientation with suture tails directed toward the acetabular rim.