The “Flying Swan” Technique: A Novel Method for Anterior Labral Repair Using a Tensioned Suture Bridge Susan Alexander, M.Sc., Ph.D., F.R.C.S., Andrew.

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Presentation transcript:

The “Flying Swan” Technique: A Novel Method for Anterior Labral Repair Using a Tensioned Suture Bridge Susan Alexander, M.Sc., Ph.D., F.R.C.S., Andrew L. Wallace, Ph.D., F.R.C.S., F.R.A.C.S. Arthroscopy Techniques Volume 3, Issue 1, Pages e119-e122 (February 2014) DOI: 10.1016/j.eats.2013.09.001 Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 1 Arthroscopic view of glenoid from anterior portal, showing an ALPSA lesion adherent medially with exposure of the glenoid neck and articular margin. Arthroscopy Techniques 2014 3, e119-e122DOI: (10.1016/j.eats.2013.09.001) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 2 (A) Axial schematic view of a Bankart lesion showing the intact periosteal hinge available for healing along the glenoid neck after the labrum is reattached. (B) Axial schematic view of an ALPSA lesion. The medial periosteal hinge has been collapsed and will be divided as the labrum is mobilized and restored to the glenoid margin. Arthroscopy Techniques 2014 3, e119-e122DOI: (10.1016/j.eats.2013.09.001) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 3 Sagittal schematic view of glenoid. (A) The single suture limbs from both the 1- and 5-o'clock anchors have been tunneled back under the labrum and out the anterior portal. After (B) passage of a suture shuttle using the Accu-Pass device at the 3-o'clock position, these suture limbs will be passed through the labrum and loaded onto the Bioraptor Knotless anchor for final tensioning after the anchor is deployed. Arthroscopy Techniques 2014 3, e119-e122DOI: (10.1016/j.eats.2013.09.001) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 4 Sagittal schematic view of completed flying swan tensioned suture bridge between 3 anchors. Arthroscopy Techniques 2014 3, e119-e122DOI: (10.1016/j.eats.2013.09.001) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 5 Schematic (A) and arthroscopic (B) views from anterior portal of repaired labrum, showing the buttress effect of the technique with the tensioned suture strands visible medially along the glenoid neck. Arthroscopy Techniques 2014 3, e119-e122DOI: (10.1016/j.eats.2013.09.001) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 6 The pattern of sutures in the tensioned suture bridge technique resembles the wings of a flying swan when viewed from the front. Arthroscopy Techniques 2014 3, e119-e122DOI: (10.1016/j.eats.2013.09.001) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions