Inside‐Out Anchor Placement: A Technique to Instrument Far Medial Anchors in Acetabular Labral Repair

Abstract


Labral tears most commonly occur anteriorly between the 12‐ and 3‐o'clock positions, with the 12‐o'clock position denoted as superior and the 3‐o'clock position denoted as anterior. When approaching the 3‐o'clock position and beyond, suture anchor placement becomes difficult given the challenging arthroscopic trajectory and an overall thin anterior rim of cortical bone for anchor purchase, resulting in a narrow angle of safe drilling. The purpose of this technical note is to present a safe and reproducible method of suture anchor placement during acetabular labral repair approaching the 3‐ and 4‐o'clock positions, with the 12‐o'clock position representing the superior anatomic location and the 3‐o'clock position representing the anterior anatomic location regardless of hip laterality. We use an inside‐out anchor placement technique to place far medial anchors, which differs from the conventional techniques (e.g., outside‐in technique) in which anchor placement is performed along the external margin of the acetabular labrum.


Technique Video



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