Posterior Labrum Repair: Two-Portal Technique.

Background: Posterior labral injuries can cause shoulder pain and instability. Posterior labral tears account for up to 47% of all tears treated arthroscopically. Injuries can result from repetitive microtrauma, recurrent posterior subluxations, or traumatic posterior dislocations. Posterior labral injuries can be reliably repaired with arthroscopic surgery. A systematic review by Delong et al found improved return to play along with lower recurrence rates when repairing these injuries using an arthroscopic approach compared to an open approach. Indications: The main indication includes a symptomatic labral tear that has been confirmed by magnetic resonance imaging. Patients commonly report deep posterior shoulder pain and can experience instability symptoms. Positive tests (Kim test, Jerk test, posterior load and shift) and findings of posterior laxity may be seen upon physical examination. Arthroscopic treatment remains the gold standard for labral repairs. Technique Description: The surgery is performed using 2 portals, an anterior (viewing) portal and a posterior (working) portal. These portals are used to place the sutures for the repair with knotless anchors. Especially in the case of shoulder instability, the capsulotomy is closed by tying a "blind" arthroscopic knot. Results: Through the use of 2 portals, the capsule labral repair is done in a clear, efficient manner. This technique aims to maximize ideal patient outcomes, including quicker return to sport, a lower rate of recurrence, and improved pain and function. Discussion/Conclusion: The main advantages of this technique are speed and efficiency. This leads to less postoperative swelling and minimal patient discomfort. Benefits also include its stepwise approach, easy reproducibility, and quality and strength of the labral repair. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.