Abstract
When utilizing knotless suture anchors during hip arthroscopy, the labrum can be either everted or inverted depending on suture passing technique to optimize the repair construct and restore the suction seal mechanism. We describe a reproductible technique, coined the Bowtie Technique, to improve suture passing efficiency while repairing the labrum with an inversion technique. Traditionally, the repair suture from a knotless anchor is passed through the chondrolabral junction, dropped off, then retrieved around the labrum to create an eversion force as the repair suture is tightened through the knotless mechanism. In contrast, an inversion technique can be performed by passing the repair suture into the central compartment, dropping it off, then piercing the chondrolabral junction with a passer to retrieve the suture. Often times, the repair suture can fall into the inferior joint and be difficult to retrieve after the passer is placed through the chondrolabral junction. With the Bowtie Technique, the suture is folded two times into a compressed coil, which looks similar to a bowtie, before being loaded into the suture passer. Once the suture is then dropped off in the joint, the bowtie expands like a spring which holds the suture in place right where you dropped it off. This suture passing technique allows for an easy and reproducible inversion repair construct.