Name: Hip Capsular Closure Using the SutureCast™ Suture Passer and LoopLoc™ Knotless Implant
Uploaded: 2026-03-02T00:00:00Z
Channel: Arthrex
Description: Benjamin G. Domb, MD (Chicago, IL), demonstrates a hip capsular closure using the SutureCast™ suture passer and LoopLoc™ knotless implant. Dr. Domb provides surgical pearls for suture management and tensioning of the LoopLoc implant to complete the closure.

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Benjamin G. Domb, MD (Chicago, IL), demonstrates a hip capsular closure using the SutureCast™ suture passer and LoopLoc™ knotless implant. Dr. Domb provides surgical pearls for suture management and tensioning of the LoopLoc implant to complete the closure.&nbsp;

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VID1-007899-en-US | A | Hip Capsular Closure Using the SutureCast™ Suture Passer and LoopLoc™ Knotless Implant

Benjamin G. Domb

A video recording of a surgical technique on a live patient in an operating room setting or a cadaveric demonstration.

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Hip Capsular Closure Using the SutureCast™ Suture Passer and LoopLoc™ Knotless Implant 

Speaker  My name is Benjamin Dome. I'm the medical director at the American Hip Institute. And today we will be demonstrating capsular closure in the hip using the suture cast passing device and the loop lock capsular closure device. The suture cast can load and expel up to 40mm of suture under the capsule. In order to load it, we switch the switch forward and then put the suture into the jaws, and we put it all the way into the apex of the jaws beneath the teeth. And then we load the suture like so. And again, if we fully retract the button, then that pulls in up to 40mm of suture. Once we've passed through the capsule, we can similarly eject that 40mm of suture like so. In order to pass the suture through the other side of the capsule, we pass the suture cast through the other side of the capsule, extend the jaws, and then use the teeth on the jaws to grasp the suture. So we want to grasp the suture very close to the apex of the jaws, and then retract like so, and pull it through the other side of the capsule. So here we're going to load the end of the fibre link from the loop lock into the suture cast. So we place it like so into the apex of the jaws, and then retract this all the way again. It can retract up to 40mm. We will then come in through the mid anterior portal. Speaker  We're going to grab the capsule just beneath the rectus femoris. So this is the indirect head of the rectus femoris here. And this here is capsule. We grab capsule just beneath the rectus femoris. And this is on the acetabular side. So we penetrate through the capsule here. And then we can inject our suture like so. And then we'll come out with the suture cast. I'm going to come in through the distal anterolateral accessory portal, which gives me a good angle to grab the capsule on the femoral side. We'll come in through the capsule on the femoral side here. And we'll use the jaws to grasp this suture. Like so. And then we pull the suture all the way through. At this point I'm going to bring both sutures into the same cannula. That. My assistant will hold on to the loop lock like so pinching the white tab against the black card. And we're going to pull through the capsule. Hold the scope please, Until we see the end of the loop block here. And at this point we'll cut. So I'll cut the fiber link. So now we take the suture off of the tab one. And we're going to pull out the suture from tab two. And we want this suture to come all the way out of the card out of tab two. And then we pass the end of this suture through the loop. Of the loop block. Speaker  And then we pass it through the wire loop attached to the white tab. And at this point we pull through using the white tab. And now we are about done with the card. And we have these two ends which we need to even up. So we're going to pull tension on that suture until our ends become even. So now with our ends close to even, we put our finger in the middle here and pull on the middle so that we have even everything up. So a pearl to minimize the friction as the loop lock is tightened, is to place a retriever into the joint and to grab the loop on both sides. So we grab the loop here and we grab the loop here. And in this way we are actually setting up a construct where the Friction will be against the retriever rather than the sutures having friction against one another. So we can lock the retriever there and then proceed with tensioning. Tensioning can be performed one suture at a time, or it can be performed with both sutures at the same time. And I'll demonstrate the latter. So let's just hold like that, please. The retriever, our assistant will hold the retriever. And I'm going to tension both sutures at the same time here bringing the mechanism down into the joint. And then when we are near, we will release the suture retriever and take it out and complete the tensioning of our loop lock. Speaker  And that completes the capsular closure in this location. We can now use a closed ended cutter to cut the remaining suture. And the closed ended cutter will pass down right on to the loop block device. So here's another view showing that capsular closure right beneath the indirect head of the rectus femoris, which has been preserved in its entirety. We'll now move on and do a second loop block for demonstration purposes. And it's interesting to note that one option is to put the first loop block in and not tension it entirely. Then pass the second loop block and then tension both sequentially. In this case, for demonstration purposes, we've tightened the first one entirely and we'll now place the second. As I open the suture cast device, note that the jaws actually open side to side in a horizontal fashion rather than vertically. Again, we'll pass the end of the suture from the fiberlink into the jaws. There. The horizontal opening makes it easier to catch the suture without catching capsule. So here we're going to come again through the acetabular side of the capsule and take our bite. And coming inside the joint. We can view as we expel the suture. And then we will come through the femoral side of the capsule. Here. Take our bite. Extend our jaws. And grab our suture and then pull it through. Hold the scope, please. As before, we pass this fiberlink all the way through. Speaker  The capsule until we see the loop lock. We'll cut the fiber link here and now. We will take off tab number two. Take the end of the suture. Pass it through the loop lock, then pass it through that nitinol wire attached to the white tab and then pull the white tab through. That. At this point, we detach from the card. And we even up our ends. So when the ends are all the way, even then we can put a finger in the middle of the loop and make sure we have pulled all the slack out of the loop. And at this point, I'm going to tension this by tensioning both at the same time. And we'll see that that slides the loop lock device all the way down to complete the fixation. And at the end we can do a little bit of tensioning of one and tensioning of the other, cut our ends and. When we pass the closed cutter down, we can actually use it as a pusher and apply some additional tension before we cut. And that completes our repair of this capsule using two loop lock devices. This accomplishes two limbs of suture around the capsule in each of the leaflets. We have an excellent closure, low profile knotless devices. So we do not have not stacks, which can potentially be a place where scar tissue can occur. And we get excellent closure with very high strength and security.