Arthroscopic Labral Repair and Pancapsular Shift With Knotless All-Suture Anchors in the Setting of Multidirectional Instability of the Shoulder

Abstract

In the management of multidirectional type of shoulder instability (MDI), arthroscopic surgical stabilization is a preferred treatment option after failed conservative therapy regimens because of the ability to easily access all aspects of the capsule with one surgical procedure. As arthroscopic techniques have evolved, factors critical to postoperative success have been elucidated. Currently, optimal arthroscopic treatment of MDI involves circumferentially restoring labral integrity, a tailored, patient-specific surgical reduction of capsular volume, and adequately managing potential lesions of the biceps anchor. The purpose of this article and accompanying video is to present our technique for arthroscopic circumferential labral repair and pancapsular shift using knotless all-suture anchors in the setting of MDI with a concurrent type II SLAP lesion.

Technique Video

Video 1

Video depicting the surgical technique for arthroscopic circumferential labral repair and pancapsular shift using knotless all-suture anchors in the setting of multidirectional instability of a patient’s right shoulder. The repair of a concurrent type II SLAP lesion also is demonstrated. The surgery is performed with the patient in a beach chair position. The diagnostic arthroscopy and anterior labral repair are viewed from a standard posterior viewing portal, and the posterior labral repair is viewed from an anterosuperior portal.