title: Recycling Suture Limbs from Knotless Suture Anchors for Arthroscopic Shoulder Stabilization.
abstract: Recurrent shoulder instability often leads to labral abnormality that requires surgical intervention that may require fixation with suture anchors. The proposed surgical technique allows the surgeon to achieve 2 points of fixation around the labrum and/or capsule with a single suture secured to the glenoid with a knotless anchor. Instead of cutting and discarding the residual suture limbs after anchor insertion, this technique uses the residual suture limbs of the knotless anchor for a second suture pass. This technique (1) creates a more cost- and time-efficient surgical procedure than using multiple single-loaded anchors or double-loaded anchors, (2) decreases the known risk of glenoid fracture from the stress riser at the implant tips of multi-anchor repairs by reducing the number of anchors required for stabilization, (3) decreases the surgical time compared with the use of double-loaded anchors through simpler suture management and less knot tying, (4) allows for the secure reapproximation of the labrum to the glenoid while offering a convenient option for capsulorrhaphy without the need to insert another anchor, and (5) yields more points of soft-tissue fixation with fewer anchors drilled into the glenoid.
authors.affiliation: National Sports Medicine Institute, Lansdowne, Virginia, U.S.A ; Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A.
authors.forename: Timothy S
authors.initials: TS
authors.lastname: Johnson
authors.affiliation: Office of Undergraduate Medical Education, University of Illinois at Chicago College of Medicine, Chicago, Illinois, U.S.A.
authors.forename: Christine M
authors.initials: CM
authors.lastname: DiPompeo
authors.affiliation: National Sports Medicine Institute, Lansdowne, Virginia, U.S.A.
authors.forename: Zahra C
authors.initials: ZC
authors.lastname: Ismaeli
authors.affiliation: National Sports Medicine Institute, Lansdowne, Virginia, U.S.A.
authors.forename: Polly A
authors.initials: PA
authors.lastname: Porter
authors.affiliation: National Sports Medicine Institute, Lansdowne, Virginia, U.S.A.
authors.forename: Shannon L
authors.initials: SL
authors.lastname: Nicholson
authors.affiliation: National Sports Medicine Institute, Lansdowne, Virginia, U.S.A.
authors.forename: David C
authors.initials: DC
authors.lastname: Johnson