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Punch Chop Needle Technique

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 LACS-Repair
  L-Type Arthroscopic Capsular Shift for unidirectional Instability

Using standard arthroscopic maneuvers shoulder surgeons can expect excellent results for arthroscopic cruciate capsular repair to correct the midsubstance ligamentous laxity rather than only repairing a bankart lesion leaving the anterior capsule redundant (Fig. 1).

This technique is easy, quick, cheap and allows anatomical reconstruction through reefing and doubling of the anterior capsular-ligament component.
1. On the neck of the head a trough is made for attachment of the ligament.

2. An L-Type incision is made to shift the inferior glenohumeral ligament capsular component superiorly.
3.

A Chop Needle placing a .suture through the edge of the prepared flap and a Chop Puller pulls the posterior limb up to the upper lateral border of the subscapularis.

4.

With the chop puller the anterior suture limb is pulled below the upper border of the subscapularis.

5.

The two ends of the suture pass below and above the upper border of the subscapularis.

A knot is tied using the concave knot driver to shift the capsule superiorly.

GOC Clinic Bonn, Germany  1990 - 2006