Placing Knotless Suture Anchor through Mid-Glenoid Portal
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Procedure Outline
Table of Contents
- The mid-glenoid portal/anterior-inferior portal should be made approximately 1 cm lateral from the joint line of the humeral head and just superior to the subscapularis through the rotator interval. Portal placement is guided by the preliminary placement of an 18 g spinal needle to ensure the trajectory of the portal is correct.
- Portal placement avoids injury to the labrum and should be determined after assessing both the thickness of the local soft tissues and the size of the relevant bony architecture.
- The drill hole for the knotless anchor should be drilled approximately 1-2 mm onto the face, or from the cliff, of the glenoid.
- The drill can be malleted down lightly to hold the drill in place while drilling anchor holes.
- The labral tape is passed a short distance through the eyelet of the knotless fixation device before the construct is inserted into the glenoid.
- The flatter, non-cylindrical labral tape provides a flat construct that wraps around the labrum to reaffix it to the face of the glenoid .
- A hemostat can be used to hold the tape as it is placed into the drill hole, and a mallet is used to drive the interference portion of the plastic implant to a marked depth on the percutaneous insertion device denoted by a black line.
- Once the suture anchor is securely affixed, the insertion device is unloaded and pulled out of the portal with 6 counter-clockwise turns.
