Arthroscopic Repair of the Acetabular Labrum Using an Anchor-First Modified Toggle Suture Technique

The goal of acetabular labral repair is to restore stable contact between the labrum and acetabular rim while maintaining the anatomic suction seal. One of the challenges of labral repair is achieving proper in-round repair, so that the labrum contacts the femoral head in the native position. This technique article presents a repair method that allows for enhanced inversion of the labrum to assist with anatomic repair. Our modified toggle suture technique utilizes an anchor-first method and has various distinct technical advantages. We present an efficient and vendor-agnostic technique that allows for straight or curved guides. Similarly, the anchors may be all-suture or hard-anchor designs that accommodate suture sliding. This technique also utilizes a self-retaining hand-tied knot construct to facilitate preventing knots from migrating toward the femoral head or joint space.