The Use of Double-Loaded Suture Anchors for Labral Repair and Capsular Repair During Hip Arthroscopy  William Slikker, M.D., Geoffrey S. Van Thiel, M.D., M.B.A., Jaskarndip Chahal, M.D., F.R.C.S.C., Shane J. Nho, M.D., M.S.  Arthroscopy Techniques  Volume 1, Issue 2, Pages e213-e217 (December 2012) DOI: 10.1016/j.eats.2012.08.002 Copyright © 2012 Arthroscopy Association of North America Terms and Conditions

Figure 1 Wave sign (patient's left hip, positioned supine). The arthroscope is placed in the AL portal and shows a wave sign in the anterosuperior aspect of the acetabulum. FAI can produce damage to the hip joint, causing a bulging or flap of loose articular cartilage that resembles the shape of a wave. Arthroscopy Techniques 2012 1, e213-e217DOI: (10.1016/j.eats.2012.08.002) Copyright © 2012 Arthroscopy Association of North America Terms and Conditions

Figure 2 Rim trimming (patient's left hip, positioned supine). With the arthroscope in the AL portal, a 5.5-mm arthroscopic cylindrical bur is used to decorticate the acetabular rim. We decorticate the acetabulum without a formal incision of the labrum to maintain the attachment of the articular cartilage to the underlying subchondral bone. Arthroscopy Techniques 2012 1, e213-e217DOI: (10.1016/j.eats.2012.08.002) Copyright © 2012 Arthroscopy Association of North America Terms and Conditions

Figure 3 Labral stitch (patient's left hip, positioned supine). With the arthroscope in the AL portal, the labrum is repaired by passing 1 limb of the double-loaded suture anchor through the labrum at the chondrolabral junction using a tissue-penetrating device and then retrieving the suture about 2 to 4 mm from initial penetration through the base of the labrum. This creates a horizontal mattress stitch to provide an anatomic repair of the labrum. Arthroscopy Techniques 2012 1, e213-e217DOI: (10.1016/j.eats.2012.08.002) Copyright © 2012 Arthroscopy Association of North America Terms and Conditions

Figure 4 T-capsulotomy (patient's left hip, positioned supine). With the arthroscope in the anterior portal, a T-capsulotomy is performed with the arthroscopic scalpel through the DALA portal. The T-capsulotomy is made perpendicular to the interportal capsulotomy and runs along the length of the femoral neck. Arthroscopy Techniques 2012 1, e213-e217DOI: (10.1016/j.eats.2012.08.002) Copyright © 2012 Arthroscopy Association of North America Terms and Conditions

Figure 5 Closure of transverse capsulotomy (patient's left hip, positioned supine). With the arthroscope in the anterior portal, capsular plication is performed through the DALA portal. The vertical portion of the T-capsulotomy is closed with numerous high-strength sutures using a suture lasso and tissue penetrator. To close the interportal capsulotomy, 1 limb of the double-loaded suture anchor is used to repair the iliofemoral ligament to the acetabulum. Arthroscopy Techniques 2012 1, e213-e217DOI: (10.1016/j.eats.2012.08.002) Copyright © 2012 Arthroscopy Association of North America Terms and Conditions