APEX Shoulder Mastering Surgical Techniques for Clinical Success-Tips for Knots and Knotless Fixation

Tips for Knots and Knotless Fixation – Is the Technique Different?

Video Transcription

Video Summary

In this video, Paul Caldwell discusses the evolution of arthroscopic labral repair techniques. He starts by giving credit to the pioneers in the field, such as Dick Casperi and Ray Thal. He explains that the initial technique involved drilling pins and passing sutures through the labrum, which was later improved with the invention of suture anchors. Over time, techniques advanced to using double loaded suture anchors, bioabsorbable anchors, and knotless techniques. Caldwell presents a case study of a high school football player with recurring shoulder instability, showing the step-by-step process of repairing the labrum using a knotless technique. He emphasizes the goals of labral repair, including mobilizing the labrum, achieving secure fixation, and avoiding prominence of knots. Caldwell discusses the advantages of knotless techniques, including smaller anchors, improved loop security, re-tensioning ability, easier tissue shifting, equivalent load to failure, and decreased risk of complications. He concludes by suggesting that knotless techniques offer several advantages and may be favorable in shoulder instability surgeries. No credits are mentioned.

Asset Caption

Paul Caldwell, MD

Keywords

arthroscopic labral repair

knotless techniques

suture anchors

shoulder instability

Paul Caldwell