The Double Bankart Bridge: A Technique for Restoration of the Labral Footprint in Arthroscopic Shoulder Instability Repair  Mohamed Aboalata, M.D., Abdelsamie Halawa, M.D., Yehia Basyoni, M.D.  Arthroscopy Techniques  Volume 6, Issue 1, Pages e43-e47 (February 2017) DOI: 10.1016/j.eats.2016.08.036 Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 1 Illustration demonstrating the double Bankart bridge construct in the right shoulder with the scope viewed in the posterior portal. Two knotted suture anchors are used at the 5:30 and 4:30 o'clock positions (2 blue arrows), and their sutures (2 red arrows) are passed again through the capsulolabral tissue at the 3 o'clock position from lateral to medial (yellow arrow) and fixed using the third knotless (PushLock) anchor (plus sign). The whole length of the footprint is under uniform pressure by the sutures of the most inferior 2 anchors, which we believe would enhance the healing between the labrum and the glenoid and decrease the amount of fibrous tissue at the healing interface. Arthroscopy Techniques 2017 6, e43-e47DOI: (10.1016/j.eats.2016.08.036) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 2 The first anchor at the 5:30 o'clock position (yellow arrow) and the second anchor at the 4:30 o'clock position (red arrow) after tying the knots and producing a south-to-north shift. The sutures are left uncut (blue arrow) (right shoulder viewed from the posterior portal in the lateral position with the glenoid marked with a triangle). Arthroscopy Techniques 2017 6, e43-e47DOI: (10.1016/j.eats.2016.08.036) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 3 The 4 suture limbs passed through the capsulolabral complex from medial (red arrow) to lateral (blue arrow) (right shoulder viewed from the posterior portal in the lateral position, showing the glenoid [triangle] and humeral head [star]). Arthroscopy Techniques 2017 6, e43-e47DOI: (10.1016/j.eats.2016.08.036) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 4 The PushLock anchor (blue arrow) loaded with the tensioned 4 suture limbs (red arrow) just before advancement into the bone and tensioning the whole construct (right shoulder viewed from the posterior portal in the lateral position). Arthroscopy Techniques 2017 6, e43-e47DOI: (10.1016/j.eats.2016.08.036) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 5 The final double Bankart bridge construct at the end of the operation showing the capsulolabral bumper (red arrow) as viewed from the posterior standard portal in the right shoulder in the lateral decubitus position. Arthroscopy Techniques 2017 6, e43-e47DOI: (10.1016/j.eats.2016.08.036) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions