Simplified Double-Pulley Remplissage With Knotless All-Suture Anchor Fixation Using a Digital Subdeltoid Retrieval Method
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 lar...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-07-01
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| Series: | Arthroscopy Techniques |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2212628725002002 |
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| author | Cody Ashy, M.D. J. Ambrose Martino, B.S. Mitchell H. Negus, B.S. Brandon L. Rogalski, M.D. Richard J. Friedman, M.D., F.R.C.S.C. Josef K. Eichinger, M.D. |
| author_facet | Cody Ashy, M.D. J. Ambrose Martino, B.S. Mitchell H. Negus, B.S. Brandon L. Rogalski, M.D. Richard J. Friedman, M.D., F.R.C.S.C. Josef K. Eichinger, M.D. |
| author_sort | Cody Ashy, M.D. |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-1677d1ca8d3447ffbb8385dbd1e90721 |
| institution | Kabale University |
| issn | 2212-6287 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Arthroscopy Techniques |
| spelling | doaj-art-1677d1ca8d3447ffbb8385dbd1e907212025-08-20T03:40:54ZengElsevierArthroscopy Techniques2212-62872025-07-0114710363110.1016/j.eats.2025.103631Simplified Double-Pulley Remplissage With Knotless All-Suture Anchor Fixation Using a Digital Subdeltoid Retrieval MethodCody Ashy, M.D.0J. Ambrose Martino, B.S.1Mitchell H. Negus, B.S.2Brandon L. Rogalski, M.D.3Richard J. Friedman, M.D., F.R.C.S.C.4Josef K. Eichinger, M.D.5Department of Orthopaedics and Physical Medicine, Medical University of South Carolina, Charleston, South Carolina, U.S.A.Department of Orthopaedics and Physical Medicine, Medical University of South Carolina, Charleston, South Carolina, U.S.A.Department of Orthopaedics and Physical Medicine, Medical University of South Carolina, Charleston, South Carolina, U.S.A.Department of Orthopaedics and Physical Medicine, Medical University of South Carolina, Charleston, South Carolina, U.S.A.Department of Orthopaedics and Physical Medicine, Medical University of South Carolina, Charleston, South Carolina, U.S.A.Address correspondence to Josef K. Eichinger, M.D., Medical University of South Carolina, 96 Jonathan Lucas Street, CSB 708, MSC 622, Charleston, SC 29425, U.S.A.; Department of Orthopaedics and Physical Medicine, Medical University of South Carolina, Charleston, South Carolina, U.S.A.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.http://www.sciencedirect.com/science/article/pii/S2212628725002002 |
| spellingShingle | Cody Ashy, M.D. J. Ambrose Martino, B.S. Mitchell H. Negus, B.S. Brandon L. Rogalski, M.D. Richard J. Friedman, M.D., F.R.C.S.C. Josef K. Eichinger, M.D. Simplified Double-Pulley Remplissage With Knotless All-Suture Anchor Fixation Using a Digital Subdeltoid Retrieval Method Arthroscopy Techniques |
| title | Simplified Double-Pulley Remplissage With Knotless All-Suture Anchor Fixation Using a Digital Subdeltoid Retrieval Method |
| title_full | Simplified Double-Pulley Remplissage With Knotless All-Suture Anchor Fixation Using a Digital Subdeltoid Retrieval Method |
| title_fullStr | Simplified Double-Pulley Remplissage With Knotless All-Suture Anchor Fixation Using a Digital Subdeltoid Retrieval Method |
| title_full_unstemmed | Simplified Double-Pulley Remplissage With Knotless All-Suture Anchor Fixation Using a Digital Subdeltoid Retrieval Method |
| title_short | Simplified Double-Pulley Remplissage With Knotless All-Suture Anchor Fixation Using a Digital Subdeltoid Retrieval Method |
| title_sort | simplified double pulley remplissage with knotless all suture anchor fixation using a digital subdeltoid retrieval method |
| url | http://www.sciencedirect.com/science/article/pii/S2212628725002002 |
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