Work

Simplified Double‐Pulley Remplissage With Knotless All‐Suture Anchor Fixation Using a Digital Subdeltoid Retrieval Method

Year: 2025

Type: article

Abstract: Anterior shoulder dislocations represent one of the most common joint dislocations, with particular populations at increased risk of recurrence. Associated bone loss further increases the risk of dislocation and often needs to be addressed via soft tissue or bony augmentation. In particular, for large Hill-Sachs lesions in patients at increased risk of dislocation, remplissage is indicated. This current technique builds upon previously double-pulley techniques and utilizes a knotless all-suture anchor construct that allows for maximization of anchor spread within an associated Hill-Sachs lesion. The knotless all-suture anchor constructs are placed percutaneously under direct visualization through a routine posterior portal. After completion of any associated labral repair, the posterior incision is expanded, and the sutures are retrieved via digital dissection to facilitate a double-pulley repair. The benefits of this technique include maximization of anchor spread, use of an already established routine portal, forgoing time-consuming arthroscopic access to the subacromial space, and a knotless construct that optimizes outcomes without compromising strength. Additionally, retrieval of the sutures under direct visualization through the expanded posterior portal decreases the likelihood of tissue bridge formation.

Source: Arthroscopy Techniques

DOI: 10.1016/j.eats.2025.103631

Authors: Cody Ashy, J. Ambrose Martino, Mitchell H. Negus, Brandon L. Rogalski, Richard J. Friedman, Josef K. Eichinger

Institution: Medical University of South Carolina

Language: English

Topic: Shoulder Injury and Treatment

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $975