Half-stained thread in shoulder arthroscopy: an improved method of suture management

Shoulder arthroscopy is used widely to treat a variety of shoulder pathologies. These include various diagnostic and stabilization procedures such as Bankart repair, treating SLAP lesions, capsular plication, and rotator cuff repair. Sutures are commonly used, particularly in stabilization procedures, with or without the use of suture anchors. Suture management is one of the prerequisites for a successful arthroscopic stabilization procedure. We describe a simple method of aiding suture management. In cases using the suture anchor, the preloaded suture is firstly removed from the anchor, and approximately half the length of the suture is stained with methylene blue. The suture is then reinserted into the same suture anchor. The suture anchor is used in the usual manner. During shoulder arthroscopy, one end of the suture is pulled, if necessary, to determine the direction of the thread, which is readily shown by the methylene blue. This simple maneuver helps the surgeon identify the desired direction of the thread and avoid the common problems of pulling out the suture and twisting the sutures.