Indications
Engaging Hill Sachs
Technique
Tips
1. Insert Hill Sachs anchors before performing bankart repair
- may be easier to do with humeral head subluxed over glenoid
- increases room to more
2. May be best to clear subacromial space before inserting Hill Sachs anchors
Posterior portal glenohumeral jont
- camera anterior portal
- debride Hill Sachs
Insert 2 x anchors
- insert both via posterior portal
- leave one set of sutures out through portal
- separate stab incision posteriorly to retrieve other set of sutures into subacromial space
- use bird beaks or suture runner
Subacromial tying
- tip: may be best to do this before passing anchors into Hill Sachs defect
- redirect posterior portal into subacromial space
- camera via lateral subacromial portal
- debride posterior subacromial space carefully to find sutures
- may want to place suture savers over sutures
Knots
- separate with birds beak
- tie these knots (white) directly
Knots / double pulley
- tie two limbs of separate anchors together
- use other limbs to oppose knots to tissue
- then tie other limbs
Camera back into glenohumeral joint
- check capsule tied down into defect
