Arthroscopic suture management

Abstract

Shoulder arthroscopy is a complex surgery, and its success depends on a wide range of seemingly minute details. The correct position of the hands and proper utilization of all available instruments is a good starting point. Suture management is fundamental because it is easy to find oneself with many sutures in a very small space without being able to distinguish between the two strands of the same suture or without knowing which of the sutures to knot first. The sutures can be passed through the tissues in different ways, depending on the type of lesion and surgical procedure to be performed, which determine the type of instrument that will be utilized. Suture passages can be performed with direct and indirect techniques. Direct suture passages are further subdivided into antegrade and retrograde. Direct passage occurs when the sutures are passed directly in the tendon whereas indirect passage requires a suture shuttle.