1. The Combined “Double Pulley”–Simple Knot Technique for Arthroscopic Shoulder Posterior Labral Repair and Capsular Shift 
Nata Parnes, M.D., Paul Carey, M.D., Monica Morman, M.D., Brian Carr, M.D. 
Arthroscopy Techniques 
Volume 5, Issue 1, Pages e37-e42 (February 2016)
DOI: /j.eats
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2. Fig 1
By use of a probe through the posterior portal, the posterior labral tear is confirmed. A left (L) shoulder is shown, in the beach-chair position, viewing through the trans–rotator cuff portal.
Arthroscopy Techniques 2016 5, e37-e42DOI: ( /j.eats )
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3. Fig 2
A Smith & Nephew Suturefix 1.9-mm double-loaded anchor is placed at the posterior-inferior edge of the tear. The same left shoulder as in Figure 1 is shown, in the beach-chair position, viewing through the trans–rotator cuff portal.
Arthroscopy Techniques 2016 5, e37-e42DOI: ( /j.eats )
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4. Fig 3
An arthroscopic simple vertical knot (arrow) is used to fix the posterior labrum. The same left shoulder as in Figure 1 is shown, in the beach-chair position, viewing through the trans–rotator cuff portal.
Arthroscopy Techniques 2016 5, e37-e42DOI: ( /j.eats )
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5. Fig 4
The 2 arms of the other suture on the anchor are retrieved through the posterior labrum and posterior capsule about 1 cm lateral to the labrum. The same left shoulder as in Figure 1 is shown, in the beach-chair position, viewing through the trans–rotator cuff portal.
Arthroscopy Techniques 2016 5, e37-e42DOI: ( /j.eats )
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6. Fig 5
A second Smith & Nephew Suturefix 1.9-mm double-loaded anchor is placed on the posterior glenoid rim (arrow) about 1 to 1.5 cm from the first anchor. An arthroscopic simple vertical knot–tying technique is used to fix the posterior labrum. The same left (L) shoulder as in Figure 1 is shown, in the beach-chair position, viewing through the trans–rotator cuff portal.
Arthroscopy Techniques 2016 5, e37-e42DOI: ( /j.eats )
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7. Fig 6
The 2 arms of the suture on the second anchor are retrieved through the posterior labrum. The same left (L) shoulder as in Figure 1 is shown, in the beach-chair position, viewing through the trans–rotator cuff portal.
Arthroscopy Techniques 2016 5, e37-e42DOI: ( /j.eats )
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8. Fig 7
One suture limb for each anchor is chosen to be coupled in a double-pulley configuration. The same left (L) shoulder as in Figure 1 is shown, in the beach-chair position, viewing through the trans–rotator cuff portal.
Arthroscopy Techniques 2016 5, e37-e42DOI: ( /j.eats )
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9. Fig 8
Fixation of the posterior capsule and periosteal sleeve is completed with tightening of nonsliding knots on the remaining suture limbs of each anchor. The same left (L) shoulder as in Figure 1 is shown, in the beach-chair position, viewing through the trans–rotator cuff portal.
Arthroscopy Techniques 2016 5, e37-e42DOI: ( /j.eats )
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10. Fig 9
(A) The adequacy of the labral repair is confirmed using a probe. (B) A balanced capsular plication is confirmed using a probe. The same left (L) shoulder as in Figure 1 is shown, in the beach-chair position, viewing through the trans–rotator cuff portal.
Arthroscopy Techniques 2016 5, e37-e42DOI: ( /j.eats )
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