Zip-tie Multidirectional Instability: A Technique for Progressive Tightening of Knotless Anchors in Multidirectional...

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Arthroscopy

Background:

• Multidirectional shoulder instability is challenging due to capsular laxity.
• Traditional arthroscopic methods risk premature tightening, complicating repairs.
• Need for precise, progressive capsular tensioning is critical.

Purpose of the Study:

• To introduce and describe the zip-tie technique for arthroscopic repair of multidirectional shoulder instability.
• To highlight the advantages of knotless, retensionable sutures in managing capsular laxity.
• To propose an alternative to traditional capsular shift procedures.

Main Methods:

• Arthroscopic knotless repair using retensionable sutures.
• Percutaneous anchor placement without initial tightening.
• Sequential, controlled tensioning after all anchors are placed.

Main Results:

• Preserves intra-articular maneuverability by delaying capsular tensioning.
• Enables fine-tuned capsular volume reduction and minimizes cartilage trauma.
• Eliminates stacked knots, potentially reducing complications.

Conclusions:

• The zip-tie technique offers a reliable and efficient method for treating multidirectional shoulder instability.
• This knotless approach enhances capsular control and may improve long-term shoulder stability.
• Provides a viable alternative to conventional capsular tightening procedures.