A range of suture passers are available for labral repair and reconstruction techniques as well as capsular closure. With a low-profile 1.5 mm outer diameter that allows precise suture placement through labral tissue, use the SwiftStitch™ suture passer for a simple or mattress suture configuration in both knotted and knotless labral repair techniques. Featuring a fast-pass trap door, the Hip Labral Scorpion™ suture passer can pass and retrieve suture in one simple step. At the end of a hip arthroscopy, the CapsuleClose Scorpion™ suture passer is designed to close the hip capsule using a straightforward and reproducible technique.

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A comprehensive overview of a product team’s portfolio.

Ein umfassender Überblick über das Portfolio eines Produktteams.

Kataloge

Visão geral e abrangente do portfólio de produtos de cada segmento.

Catálogos

Descripción general y completa sobre la cartera de productos de cada segmento. 

Catalogs

Hip Next Generation in Soft-Tissue Repair and Reconstruction

A document containing information about Arthrex products and product lines.

Ein Dokument mit Informationen über Arthrex Produkte und Produktlinien.

Broschüren

Documento contendo informações sobre produtos e linhas de produtos da Arthrex.

Brochuras

Documento que contiene información sobre los productos y líneas de productos de Arthrex.

Folletos

Brochures

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

This animation features the 1.8 Knotless Hip FiberTak® anchor used with a SwiftStitch™ suture passer to create a labral base stitch through the acetabular labrum.

video

A general overview including the relevant steps of an Arthrex surgical technique. These animations always include a voice-over explaining the process.

Eine allgemeine Übersicht, einschließlich der relevanten Schritte einer Arthrex Operationsanleitung. Diese Animationen enthalten immer Voice-Overs, die den Prozess erklären.

Operationstechnik-Animationen

Visão geral incluindo as etapas relevantes de uma técnica cirúrgica Arthrex. Essas animações sempre incluem uma narração explicando o processo.

Animações de técnicas cirúrgicas

Descripción general que incluye los pasos relevantes de una técnica quirúrgica de Arthrex. Estas animaciones siempre incluyen una voz en off que explica el proceso.

Animaciones de técnicas quirúrgicas

Surgical Technique Animations

Hip Labral Repair Using the 1.8 Knotless Hip FiberTak® Anchor and a Labral Base Stitch

Hip label repair with the 1.8mm Knotless hip FiberTak anchor labral base stitch. Use a retractable hood bur to complete an acetabular plasty and prepare the rim for anchor placement. Place a 20 degree curved drill guide on the acetabular rim, and use a flexible drill pin to create a pilot hole for anchor insertion. Insert a knotless hip FiberTak anchor through the drill guide and impact the handle by hand to a positive stop. Initially, set the anchor in bone by grasping the sutures and pulling the handle proximally. Remove the handle and pull all of the sutures to confirm the anchor is adequately set in bone. Remove the drill guide from the cannula and load a short tale of the white portion of the repair suture into the jaws of the SwiftStitch suture. Passer. Advance the SwiftStitch suture. Passer down the cannula and push it through the base of the labrum. Depress the black button and push it forward to release the suture into the joint. Pass the SwiftStitch through the mid substance of the labrum and retrieve the suture, and pull out all slack from the suture outside of the cannula. Pass the white end of the repair suture through the loop of the shuttle suture, and pull the non looped end of the shuttle suture until resistance is felt. Gently pull 3 to 4 light tugs to pass the repair suture back through the anchor sheath. Pull on the repair suture to get the initial tension outside of the cannula. Load the repair suture into the suture tensioner. Cutter for final tensioning and cutting. Insert subsequent anchors to complete the labral repair.

A video of a live presentation reviewing Arthrex products or techniques.

Video einer Live-Präsentation, die Arthrex Produkte oder Techniken überprüft.

Präsentationsvideos

Vídeo de apresentação ao vivo analisando produtos ou técnicas da Arthrex.

Apresentação vídeos

Video de presentación en vivo que revisa los productos o técnicas de Arthrex.

Video presentaciones

Presentation Videos

Techniques and Treatment Outcomes in Knotless Hip Labral Repair

I'm going to be talking about techniques and treatment outcomes in knotless labor repair. So the labrum has a function. It increases the acetabular surface area and volume. It controls fluid flow. It provides a suction seal which is important for stability. It protects the cartilage from compression and it reduces contact stresses on the articular cartilage. The labrum has a very unique anatomy in the hip. There is this spike of bone that we've seen this this different image in this anatomy slide several times. There is a part of the labrum that contacts the capsule. And then there's where you get a lot of the blood supply to the labrum. And then there's a part of the labrum that goes down to contact the articular cartilage to create this transition zone. There are many ways to refix or to repair the labrum. There's a simple and looped SwiftStitch sutures. There's base fixation. And there are some other more anatomic atomic options using the Knotless SutureTak that will go through as well. You need to know how to do every one of these because certain situations are going to require different techniques. What are the benefits of a simple or a looped stitch? In this case, this is a image showing a doubled over suture that has been looped on itself to really grab the circumferential fibers. So when you have a pincer lesion and you have that highly degenerative labrum, where it's creating that fraying of the labrum itself, you want to wrap those sutures circumferentially to make sure that you have a stable repair. What's the downside is that you can Evert the labrum. If the purpose of the labrum is to contact the femoral head. And then we needed to stay there. So if you're if you're doing a refixation or a labor repair and you're significantly everting the labrum, then I question whether we're doing our job. What's the difficulty using these techniques? We'll go through some of that stuff as we go on. So here is an option of where I would use that technique. So this patient has an OS and they have some intra labral degeneration. So in this case they had a combined mix. So they had a pincer lesion. They had this with this OS. And then they had a Cam deformity causing this transitional zone delamination. In this particular case we removed some of the tissue around the OS and then we start to remove it. I like to use a burr from the capsular side. I start to burr this down in a gross fashion, staying away from the labrum, making sure that we are not destroying any of the quality labral tissue. When we've created more of a thin component, I'll come in with a biter or whatever device I have, that pituitary rongeur or something that that nature, again, we are we are trying to take out just the unstable portion of this and leave the remaining fibers of the labrum to repair and to refix. We're going to do our pincer resection, we're going to prepare our rim. And then in this case we did a looped fixation. And we had enough labrum in this situation to do a loop repair. We did not invert it. And then we are able to recreate a suction seal. As you see right here. So that's your classic simple loop. It's the easiest one. It's probably the the one everybody should start off with. If they're not doing a lot of labor repair. But then we evolve. So the concepts of base fixation has been around for a while. Doctor doom wrote it up in arthroscopy I believe it was 2013 with some nice diagrams to give you a better, better idea, but there's also big variations on how you do this. What's the benefit to a base fixation? More AnaToemic. You get improved labral contacts so it can do its job. It's more demanding. You do violate the labrum in some degree, which can affect stability. So in this situation, we've drilled our pilot hole. We're going to do this Knotless. This is an older video where I'm using a BirdBeak. Now we use the Scorpion and we're also using SutureLasso. I believe there's also some micro lassos coming out. So you have even less of a violation. But on this more hypertrophic larger labrum you can come through with a simple BirdBeak. Then I come, I come usually where there's a little blush or change in the tissue, and I will come right at that junction and pierce through again. You can do this with the labral Scorpion, which works quite nicely for these larger labrums. You can do it with a lasso. There's varying techniques. We're going to grasp that. Slide it back up through. Then I'm using a short PushLock Biocomposite PushLock in this case. The other benefit to this base fixation is you can move your anchor a little further away from the rim than you'd like to to do, and that what's the benefit of that? We don't get those articular cartilage penetrations that we have all experienced. Or hopefully we're looking at the articular cars and we just start to see a little wave in it and we stop ourselves. But when you're doing this base fixation, you can definitely scoot a millimeter or so further away from the articular surface to avoid performing a iatrogenic penetration of the articular cartilage. Here's just a second anchor going in. I have actually converted to using an OA FiberWire when I'm using these PushLock because I there's less friction in binding, so I get less eversion, especially if I'm doing a cinch stitch. There's our anchor going in. And here's a nice view of the undersurface. You've left that leading edge. You've still got a nice controlled repair, minimal suture on the articular surface. And now we'll go to the next topic, which is a more anatomic fixation. So the new knotless SutureTak. What are the benefits of it. Even more anatomic options. It was peek. The one I've used was peek. But I understand that there's a biocomposite that just came out. Hopefully they can confirm but I'm pretty sure of that. You get improved label contact. You get much greater control of being able to tension it. And unlike some other devices from other companies that have a situation where you can tension, after you've placed your anchor, you're able to remove the device or the handle. So you can actually visualize as you're doing this, which is different than some of them, you can place this blind. So if you've if you've done a repair and then you realize you got to go back far anterior or to that 9 or 3:00 position Depending on what hip you're doing, this can be a great anchor for that too. It is more demanding and there are some there are some subtleties with it. This is just from the Arthrex literature. This is available online. You can watch videos of this Truefitt cannula. I've switched to this at this point. It's awesome if you guys haven't used this. The way it grips at the skin, the way you can trim it down, it's it's a game changer compared to the rigid ones. So in this situation you can get very close to the rim here. You're going to impact this. Here's that. Scorpion coming through. And then you're going to shuttle your suture through. And when you're finished you're going to have the nitinol guidewire coming from the capsular side outside of the joint. You're going to be passing it through the night all guidewire. And now you can after it's down, you can tension it and it and you can. It's a one way catch so you don't. That's it. It's loose. Now you're going to slowly, bit by bit with the inserter out you can slowly tension it down. It's got a lot of benefits and I know I don't know if Ben's still here, but I think he's doing this almost exclusively. Here's just coming from a different angle angle. And then you get this. You can also pass this in a base stitch fashion. You can use it in any technique you want. This was a more thin labrum. So I decided to wrap it around. Data. Not a lot of data looped versus pierced was looked at through Philippon in 2015 didn't show a difference. Doctor doom showed that the base stitch works more recently, however, in 2016, the biomechanical article came out which showed that vertical mattress configurations versus horizontal were superior, and the smaller the device that penetrates the better. So that's why moving away from a BirdBeak like I showed in here, moving more towards the meniscus. I mean, the labral Scorpion moving towards micro lassos, those kind of things can be beneficial. So there are different suture options. There's FiberWire, there's LabralTape, there's SutureTape, there's all sorts of different materials. You can use different angled lassos, just like we're using in the shoulder. Play around with all these things. Have your have your reps, bring them in and see what you like the most. Pushlock anchors. We got all different types. We've got short, we got peak, we got Biocomposite and then play around with the suture Knotless SutureTak get used to it. It's good to have in your arsenal. Pearls stabilize the labrum. If it's a big labrum you've got options. You can do base stitch if it's small and if it's beat up in doubt, wrap it. That's my opinion. Restore the normal anatomy. Anything you need to do to to to do that. Occasionally I'll try to put a cinch suture around on a smaller labrum, and I will start to feel like I'm everting the labrum. I'm going to pull it away, it away. And you're not going to get your suction, steel. Be willing, if you have to, to burn an anchor in that situation. Change your technique and do something different. If you don't have the right angle and you're going to bubble the cartilage like I showed, back off, go to a distal mid anterior portal so that you get to different angle. Be willing to challenge yourself and use some different techniques. You're going to make some mistakes. You're going to you're going to pop through the cartilage. It's going to happen if it hasn't already, to you just try to do everything you can to limit those mistakes and to have a bunch of options to get you out of a jam. My favorite thing in fellowship with Peter Millett and shoulder surgery was when we'd fix something and he would pull a towel off the tray, and it had all I was allowed to use to fix something. And it would be a nitinol guidewire and a suture and and a and a and a and a 18 gauge spinal needle. And it was in one anchor and that was. That's all you had. It's fun to challenge yourself doing the same thing over and over again. We can tend to get a little complacent. So I challenge you.

Craig Mauro, MD, (Pittsburgh, PA) presents his knotless acetabular labral refixation technique using LabralTape™ suture and a 2.9 mm Hip PushLock® anchor to create a strong and low profile knotless construct. He outlines his suture passing technique using the Hip Length Crescent SutureLasso™ suture passer and discusses pearls for using the LabralTape to adequately position the labrum against the femoral head and maintain the suction seal of the joint.

Use of LabralTape™ Suture for Knotless Labral Refixation in the Hip

As we all probably know, LabralTape is a smooth, low profile polyethylene suture, which really is complemented well with 2.9 PushLock and around the hip. That's what I primarily use. But it can also be used with 3.5mm swivel locks. It provides a very wide footprint for a knotless suture, and it distributes the load over a wide area. It's been shown to have 39% higher tensile strength than FiberWire. And John Cristoforetti had a paper, as well as Arthrex white paper showing the tissue tear through risk with LabralTape and FiberWire has really been shown to be about 37% stronger with in comparison to FiberWire and with pull out and tear through tissue strength. So really is a strong construct. Its first been was used in the shoulder. It's been used for shoulder instability. It's been used for slap repairs to get rid of the knot stack below the rotator cuff. And really has been effective for shoulder surgeons as well. So in the hip, some of the some of the discussion points that I want to talk about, which Tim started getting into was some of the suture configurations where we can use LabralTape, as well as its considerations of it being a better biologic scaffold. And I'm going to show some pictures of that, its use in reconstruction. And then we'll talk through a case with a few technical pearls. So this figure was just shown the primary issue in my practice. I really like to try to achieve a labral base repair if I can, but I'm going to show some examples. For example, the LabralTape can be used in a simple stitch configuration, and we've probably all done this and seen it particularly for small labrum for a labral tear with a lot of intra substance tearing. As Tim was saying, that's when I'll use a simple stitch, and it really provides excellent fixation. And we can still achieve that suction seal effect between the femoral head and the the labrum using a simple stitch configuration. Typically base refixation techniques, as we've all seen here today, rely on either sutures and knots to to refix the refix the base in a more AnaToemic situation. The LabralTape can be used, and I'll show an example of this in our case, to restore that same suction seal type of alignment between the labrum and the femoral head. With with using the tape as well. So, so I think this is the goal that I'm trying to achieve most often with the, with the LabralTape is a fixation using a base fixation technique. And and we'll go through that. So I think one of the other interesting things about the LabralTape, Peter Millett, showed some pictures a couple of years ago at the faculty forum of the FiberTape and the rotator cuff, where the basically had revascularized and was completely covered by by the host tissue within 6 to 8 weeks after after the rotator cuff. And I had an initial experience with this from a case a couple of years ago where I had just first started using LabralTape. I had fixed it in a simple fashion around the labrum. And this patient, you know, a year later, was still having some symptoms. We ultimately went back for revision arthroscopy and saw that the did a small capsule capsule scar release. But basically she had completely overgrown with synovial tissue that that that LabralTape. So I think provides a nice biologic scaffold because of the, the way the LabralTape is configured. So I think it's also really helpful for reconstruction. And when you're faced with this situation where you have, you know, labral deficiency, I've been really happy with LabralTape in this situation, fixing first the ends of the reconstruction down using FiberWire stitches and PushLock. But then in a simple circumferential loop construct, fixing the graft down using LabralTape. For me, you know, it provides that very strong. Fixation, which I think you can achieve the labral seal and still get that biologic component that we just talked about there. So for me, those are kind of some of the some of the main issues I think of with the LabralTape. And I'm going to use one case to illustrate how I use it in my practice. So this is a 28 year old male soccer player. Typical FAI. I had treated him with a right hip arthroscopy about a year ago, and recently we went through his left hip. Had large cam deformity. So a pretty classic case. On initial inspection, he's got a large chondrolabral injury. Delaminated cartilage detachment of his anterior-superior labrum. Typical cam fashion. So I think in using LabralTape and knotless fixation techniques, some of the keys are that you really need to be especially fastidious with your rim preparation because the visualization visualization is paramount with with knotless fixation. So I think that really clearing the the bony rim impingement lesion is key with, with this type of technique. Decorticating the bone. And then as we talked about in the earlier session, adjusting your rim resection as needed based on your preoperative planning, but this really can't be done. I don't think adequately without visualizing your your rim. So I do a peel back technique, which we've talked about earlier, and I think this is really key with the with the LabralTape and PushLock configuration is to really get good exposure in this area. This is viewing from mid anterior portal back onto a left hip. We prepare our bed. And then at this point I like to look at the labrum and decide what type of suture configuration is best for the for the type of labrum. So if there's a lot of intra substance tearing, I also will do a simple suture configuration. If the labrum itself is is healthy and strong enough, then I think it's appropriate for a base fixation technique using the LabralTape. So I'll initially usually begin at the 12:00 position. Here's using a crescent suture passer to pass through the chondrolabral junction. And you can, you know, use a number of different techniques. You can use a Penetrator and just pass the LabralTape. In this case, I like the crescent because it pokes a small hole through the labrum or through the chondrolabral junction without disrupting it. Here we've still got a lesion, which I usually deal with after we've refixed the labrum. We pass our LabralTape in a simple fashion, and at this point, you can fix it back to the acetabulum and standard circumferential loop fashion or proceed with your mattress fixation. So I again am using a crescent suture passer here to poke through the labrum. There are a number of different commercial devices. You can just use a penetrating suture passer and grab the labrum. And then we shuttle the LabralTape back up through to create that vertical mattress type of configuration. For me at this point I like to then identify I'm viewing through the mid anterior and I'm passing through the anterolateral portal. I like to shuttle to the distal anterolateral portal because I think that gives me better, a better drilling angle. So this is just an example from viewing from the mid anterior portal. What we get with trajectory from the distal anterolateral portal versus the anterolateral. So we'll shuttle this LabralTape out the distal anterolateral portal. And then I'll start drilling once I have my tape in place immediately adjacent to the contralateral junction. If you're coming from the distal anterior lateral portal, I think you have a nice trajectory and you don't have to worry about coming out in the surface. You really want to make sure that your your drill hole is freed of soft tissue and that you can visualize it well for placing your PushLock. And then we advance to the PushLock basically, pull the fixation back down to the acetabular rim where we want it just in the last half of the anchor. So we got our 12:00 anchor and then we move medially. And the thing I like about it with the LabralTape is there's no suture wad. You know, I don't think it decreases scarring between the capsule and labrum. There we move more medially and again achieve some of the same positioning issues. We can look at the the labrum, which has been refixed. There's no suture wad. It's a strong reflection of the refixation of the base there with three anchors recreating an excellent suction seal. And I do a capsule repair on all these. I do a t capsulotomy, and I'm doing 4 or 5 stitches to close the capsule at the end. So my experience with this is over the last couple of years, done 2 or 300 cases with this and really been happy with it. I haven't noticed any anchor pull out tape failure I think, which is the consensus. It seems here it's well suited for large tears. If they're macerated and there's intra substance tearing, I do a simple circumferential configuration. If there's a healthy labrum, I'll do a mattress configuration. And I think the key points are to pay special attention to your rim preparation, your drilling angle as to not torque, and the LabralTape tension, which I think is probably the most important thing to get an anatomic repair.

The labrum enhances joint stability and congruity by deepening the socket and creating a suction-seal mechanism. The suction-seal resists joint fluid extrusion on compression, thus protecting the articular cartilage from supraphysiologic loads. A deficient labrum compromises this mechanism and results in increased joint compressive forces that may cause early degenerative changes.

A step-by-step demonstration of how a product would (or could) be used in a surgical technique.

Eine schrittweise Demonstration, wie ein Produkt in einer Operationsanleitung verwendet werden würde (oder könnte).

Operationsanleitungen

Demonstração passo a passo de como um produto seria utilizado em uma técnica cirúrgica.

Guias de técnicas cirúrgicas

Demostración paso a paso de cómo se utilizaría un producto en una técnica quirúrgica.

Guías de técnicas quirúrgicas

Surgical Technique Guides

Acetabular Labral Reconstruction using the Knotless PushLock™ Anchor System

Hip Labral Scorpion™ - Simplified Single Portal Suture Passing and Retrieving

SwiftStitch Suture Passer, Hip Length, Crescent

SwiftStitch, Fadeneinzugshilfe, hüftlang, halbmondförmig

SwiftStitch Suture Passer, Hip Length, Crescent

Pasador de sutura SwiftStitch paraartroscopia de cadera, crescéntrico

PASSADOR DE SUTURA SWIFTSTITCH , QUADRIL, CRESCENTE

Nadeln für Scorpion Nahtzange, Hüftlänge

SutureLasso for Hip Arthroscopy, 45°, Right Curve

SutureLasso für Hüft Arthroskopie 45° Biegung Rechts

SutureLasso for Hip Arthroscopy 45° Curve Right

SutureLasso para artroscopia de cadera, 45°, curva derecha

SUTURELASSO PARA ARTROSCOPIA DE QUADRIL CURVADO 45 DIREITA

SutureLasso for Hip Arthroscopy, 45°, Left Curve

SutureLasso für Hüft Arthroskopie 45° Biegung links

SutureLasso for Hip Arthroscopy 45° Curve Left

SutureLasso para artroscopia de cadera, 45°, curvaizquierda

SUTURELASSO PARA ARTROSCOPIA DE QUADRIL CURVADO 45 ESQUERDA

SutureLasso for Hip Arthroscopy, Crescent

SutureLasso para artroscopia de cadera, crescéntrico

SUTURELASSO PARA ARTROSCOPIA DE QUADRIL CRESCENTE

SutureLasso for Hip Arthroscopy, 90°, Straight

SutureLasso für Hüft Arthroskopie 90° Gerade

SutureLasso for Hip Arthroscopy 90° Straight

SutureLasso para artroscopia de cadera, 90°, recto

SUTURELASSO PARA ARTROSCOPIA DE QUADRIL 90 RETO.

Disposable Suture Passing

Educational Resources and Products

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Documents

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Surgical Technique Animations (1)

Hip Labral Repair Using the 1.8 Knotless Hip FiberTak® Anchor and a Labral Base Stitch

Surgical Technique Guides (1)

Acetabular Labral Reconstruction using the Knotless PushLock™ Anchor System

Brochures (2)

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

Hip Labral Scorpion™ - Simplified Single Portal Suture Passing and Retrieving

Catalogs (1)

Hip Next Generation in Soft-Tissue Repair and Reconstruction

Presentation Videos (2)

Techniques and Treatment Outcomes in Knotless Hip Labral Repair

Use of LabralTape™ Suture for Knotless Labral Refixation in the Hip

SwiftStitch Suture Passer (1)

AR-4068HL

Scorpion Suture Passers (4)

AR-16991

AR-16991N

AR-16992

AR-16992N

Hip Length SutureLasso (4)

AR-4068-45RH

AR-4068-45LH

AR-4068CH

AR-4068-90H