Labral Repair of the Acetabulum Using a Toggle Suture Technique

Abstract

Acetabular labral repair requires positioning the labrum on the edge of the acetabulum with appropriate tension and rotation to recreate the suction seal with the femoral head. Considering that the labrum is a triangular shape in cross-section, rotation of the articular face of the labrum relative to the femoral head also affects the suction seal. The purpose of the toggle suture technique described herein is to control the rotation of the labrum to allow the articular face to directly contact the femoral head and optimize the suction seal. The technique is performed by passing the midaspect of a suture around the labrum at the chondrolabral junction. The loop is retrieved and delivered outside the same portal. One of the 2 free suture tails is then passed through the loop, which is then manually tensioned. This creates a single loop around the labrum with a suture tail on either side that allows for rolling, or “toggling,” of the labrum to place the articular face in line with the femoral head.

‘Mini-Max’ knotless acetabular labrum repair: repair construct rationale and allocation in a consecutive case series with minimum 1-year clinical outcomes

“…Precise placement of sutures, anchors and careful re-tensioning of the labrum are imperative for restoring the suction seal [ 1 , 4 , 7 ]. Various labral repair techniques have been described, including simple loop, cinch, modified cinch and a labral base repair technique without clear superiority of one technique [ 4 , 8 , 11 ]. A wide selection of sutures, anchors and materials from different medical manufacturers allow orthopedic surgeons to select the appropriate equipment based on their personal preferences and abilities [ 4 , 8–10 ].…”

Arthroscopic Repair of the Acetabular Labrum Using an Anchor-First Modified Toggle Suture Technique

“… 1 , 9 Carl Wierks presented a technique that utilizes a knotless PushLock method resulting in a toggle suture that allows for rotational adjustment of the labrum and in-round repair. 11 Our technique creates a similar toggle suture with a number of distinctions ( Table 2 ). This technique begins with placing the anchor into the acetabular rim before passing the suture.…”

Maximizing the Benefits of Postless Hip Arthroscopy: On-Off Traction Technique During Labral Repair to Restore the Labral Suction Seal

“… 1 Another option for effective repair is using the knotless tensionable suture anchor technique that uses looped suture configuration in order to selectively tension the labrum into an anatomic position without excessive eversion of the labrum. 6 , 7 , 8 , 9 , 10 The authors of this technique suggest shorter operative times and the use of only 1 to 2 working portals. 7 Jackson et al.…”