Arthroscopic Repair of Inferior Labrum Anterior to Posterior Lesions of the Shoulder Using a Combined “Double-Pulley” Simple Knot Technique Nata Parnes,

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Arthroscopic Repair of Inferior Labrum Anterior to Posterior Lesions of the Shoulder Using a Combined “Double-Pulley” Simple Knot Technique Nata Parnes, M.D., Maryellen Blevins, R.P.A.-C., Brian Carr, M.D., Paul Carey, M.D. Arthroscopy Techniques Volume 5, Issue 4, Pages e685-e690 (August 2016) DOI: 10.1016/j.eats.2016.02.027 Copyright © 2016 Terms and Conditions

Fig 1 Viewing through the trans-cuff portal in a left shoulder, the inferior labrum anterior to posterior lesion (arrow) is confirmed using a probe. Arthroscopy Techniques 2016 5, e685-e690DOI: (10.1016/j.eats.2016.02.027) Copyright © 2016 Terms and Conditions

Fig 2 Viewing through the trans-cuff portal in a left shoulder, the posterior-inferior labrum (L) is fixed and the posterior band of the inferior glenohumeral ligament is reconstructed using an arthroscopic simple vertical knot (arrow). Arthroscopy Techniques 2016 5, e685-e690DOI: (10.1016/j.eats.2016.02.027) Copyright © 2016 Terms and Conditions

Fig 3 Viewing through the trans-cuff portal in a left shoulder, the anterior-inferior labrum (L) is fixed and the anterior band of the inferior glenohumeral ligament is reconstructed using an arthroscopic simple vertical knot (arrow). Arthroscopy Techniques 2016 5, e685-e690DOI: (10.1016/j.eats.2016.02.027) Copyright © 2016 Terms and Conditions

Fig 4 Viewing through the trans-cuff portal in a left shoulder, the 4 limbs of the 2 sutures are retrieved through the posterior portal, paying attention to retrieve the suture limbs from the anterior anchor (A) inferior to the inferior labrum (IL). Arthroscopy Techniques 2016 5, e685-e690DOI: (10.1016/j.eats.2016.02.027) Copyright © 2016 Terms and Conditions

Fig 5 One suture limb for each anchor (1, 2) was chosen to be coupled in a double-pulley configuration. Arthroscopy Techniques 2016 5, e685-e690DOI: (10.1016/j.eats.2016.02.027) Copyright © 2016 Terms and Conditions

Fig 6 Fixation of the inferior labrum anterior to posterior lesion is completed with tightening of nonsliding knots on the remaining suture limbs of each anchor. As viewed from the trans-cuff portal in a left shoulder, the completed double-pulley construct secures the inferior labral tear (L) between the 2 anchors (1, 2). Arthroscopy Techniques 2016 5, e685-e690DOI: (10.1016/j.eats.2016.02.027) Copyright © 2016 Terms and Conditions

Fig 7 At the end of the procedure, the adequacy of the repair is confirmed using a probe, viewing through the trans-cuff portal in a left shoulder. Arthroscopy Techniques 2016 5, e685-e690DOI: (10.1016/j.eats.2016.02.027) Copyright © 2016 Terms and Conditions