Arthroscopic Knotless Anchor Bankhart Repair | All Suture Repair | Shoulder Surgeon Vail, CO скачать в хорошем качестве

Arthroscopic Knotless Anchor Bankhart Repair | All Suture Repair | Shoulder Surgeon Vail, CO

https://drmillett.com The procedure begins by performing a standard posterior portal followed by a high anterior superior portal through the rotator interval. A standard diagnostic arthroscopy is performed, looking for pathology in the anterior inferior labrum. The arthroscope is then placed into the inferior recess to evaluate for loose bodies and the bicep tendon is probed to evaluate for stability. Lastly, probing is done on the superior labral complex, bicipital root, and the superior posterior portion of the humeral head evaluating for Hill-Sachs lesion. The frayed edges of the anterior inferior labrum are debrided with an oscillating shaver. A periosteal elevator is used to immobilize the capsule labral tissue. Next, an anterior-inferior portal just above the upper border of the subscapularis tendon is placed, followed by the placement of an 8.25 mm cannula. A hooked electrocautery device is used to further elevate the capsule labral sleeve in a superior direction to further its mobilization. With the use of an oscillating burrow, the glenoid neck is fully free from soft tissue until a bleeding surface is established. This is completed to facilitate bone to capsule healing. A small arthroscopic A-traumatic grabber device is used to demonstrate the full mobility of the capsule labral tissue. A curved drill guide, along with a flexible drilling pin, is used to place an all suture soft anchor. A cannulated drill guide is placed through the anterior inferior portal set the 5:30 position, 1 to2 millimeters medial to the glenoid rim. The all suture anchor is placed through into the bone tunnel, initially by hand, and then fully seated with the use of a mallet. A working repair suture is then shuttled out of the anterior superior portal. A curved arthroscopic suture lasso is placed through the anterior inferior portal deep and inferior to the anchor. This is done along with the aid of an arthroscopic grasper to place the soft tissue on tension and further facilitate a superior and medial eyes and capsular shift. Duluth nitinol wire is passed and shuttled into the portal and the repair suture from the anchors is placed into the loop of the wire and shuttled through the anterior superior portal. The repair suture from the anchor is placed into the loop of the wire and then shuttled through the soft tissue as it exits out the anterior inferior portal. The anchor is pre-tensioned and an arthroscopic Grabber is then used to grab the capsule to allow for an anatomic reduction next to the face of the glenoid. The suture is then cut flush to the face the glenoid while sequential anchors are placed in a similar. The final repair construct is probed thoroughly to ensure complete stability of the new reconstructed labrum. Final arthroscopic visualization can be seen by switching the arthroscopic visualization to the anterior superior portal.