Arthroscopic Bony Bankart Repair Using a Double-Row Double-Pulley Technique

We propose an arthroscopic technique called “double-row double-pulley” to restore a bony Bankart lesion. This technique is a 2-point fixation construct using the sutures from a medial row anchor at the glenoid neck to wrap around the bony Bankart fragment and tie to the sutures from a lateral row anchor at the glenoid rim with the double-pulley method. This technique may present some difficulty with suture management, but there are several advantages. First, due to the 2-point fixation, the risk of a bone piece fracture from direct penetration is minimized. Moreover, the fragment can be reduced directly due to the multiple knots that are tied sequentially over the bony fragment.