The suture-weave technique: a method of reloading a deployed unloaded suture anchor

Many suture anchors hold 2 sutures per anchor. Occasionally during a procedure, 1 of these sutures may be inadvertently pulled out of the anchor eyelet. We describe the technique of rethreading a deployed suture anchor in the event that 1 of the sutures is inadvertently unloaded from the anchor eyelet. We have evaluated its effectiveness in vivo. The basic steps of the "suture-weave" technique are as follows. If 1 strand remains threaded through the anchor eyelet, it is tensioned so that there is 1 long end and 1 short end. The free suture is threaded into the eye of a graft preparation needle and this needle is then used to pierce the braids of the long end of the threaded suture. The free suture is interwoven through the braids of the threaded suture. The short end of the threaded suture is then pulled while visualizing the anchor eyelet arthroscopically. The free suture passes through the eyelet as the intersection of the 2 woven sutures traverses the eyelet. During this process, 3 suture strands are traversing the eyelet. Finally, the intersecting suture limbs are pulled free from each other such that there are 2 separate suture strands that slide independently and pass through the anchor eyelet once again. This procedure has been successfully used in vivo without complications. It is important to note that this procedure will only work in an anchor eyelet that will allow for the passage of 3 suture strands.