Labral Repair of the Acetabulum Using a Toggle Suture Technique.

Abstract

Acetabular labral repair requires positioning the labrum on the edge of the acetabulum with appropriate tension and rotation to recreate the suction seal with the femoral head. Considering that the labrum is a triangular shape in cross-section, rotation of the articular face of the labrum relative to the femoral head also affects the suction seal. The purpose of the toggle suture technique described herein is to control the rotation of the labrum to allow the articular face to directly contact the femoral head and optimize the suction seal. The technique is performed by passing the midaspect of a suture around the labrum at the chondrolabral junction. The loop is retrieved and delivered outside the same portal. One of the 2 free suture tails is then passed through the loop, which is then manually tensioned. This creates a single loop around the labrum with a suture tail on either side that allows for rolling, or "toggling," of the labrum to place the articular face in line with the femoral head.