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Benton A. Emblom, MD (Birmingham, AL), repairs a gluteus medius tendon using a double-row tendon compression bridge.

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Endoscopic Double-Row Gluteus Medius Repair Using the Gluteus Medius Repair System

I'm Benton emblem. I'm an orthopedic sports medicine surgeon in Birmingham, Alabama at Andrews Sports Medicine and Orthopedic Center. What we're going to demonstrate today is a partial thickness gluteus medius tendon repair. I see a good bit of these in middle aged women between 50 and 60 that have lateral hip pain, that often complain of discomfort for a year at least, that are treated empirically for gluteus medius tendinitis and or trochanteric bursitis. An MRI typically is obtained and shows a partial thickness gluteus medius tendon tear. These can be easily repaired endoscopically with a 30 or a 70 degree scope from the trochanteric space utilizing knotless suture anchors. We're going to demonstrate the repair of a partial thickness gluteus medius tendon tear, utilizing the 2.6 Knotless gluteus medius Tendon repair Kit. In this kit includes the drill guide and drill. The two anchors knotless 2.6mm the Millimeters the cutter. And in this instance we're going to utilize two additional anchors to create a two row or double row configuration repair. So we're established in the trochanteric space of the hip. This is a right hip proximal distal. Our two portals that we've created so far are a mid lateral portal. This is approximately four centimeters or a finger four fingerbreadths distal to the kind of the mid greater trochanter. And this is our standard anterolateral portal. So what we've done up to this point is we've prepared the trochanteric space by doing a complete bursectomy. We've identified the gluteus Maximus sling right here, which is our distal posterior landmark. And then this is our gluteus medius gluteus minimus muscle tendon complex. And this is the vastus lateralis. If you note the vastus lateralis has a very distinct sheen to it. And it's typically what I call the lighthouse of the trochanteric space. So in some in some cases of partial gluteus medius tendon tears, if the tendon length is pretty short, we'll typically do a single row knotless compression bridge construct and others where the tendon length is more substantial. We'll do a two row where we'll utilize four anchors. In that case, we'll typically develop an X footprint configuration by putting two anterior anchors and two posterior anchors. In that case, we'll take our anterior superior anchor and feed it and couple it with the posterior inferior anchor. And then once that's converted, we'll take our anterior inferior anchor here and convert it and couple it with the posterior superior anchor. So we'll put our first anchor in here. Oftentimes you have to manipulate the leg so that the trajectory of the drill is appropriate to prevent from skiving. So in this case you can notice that this drill guide is aiming somewhat tangentially to the proximal aspect of the femur. So we're going to have our have our assistant internally rotate the femur so that it'll bring the proximal femur a little bit more internally positioned. So we'll put our first anchor in right here which is going to be our anterior superior anchor. This is going to be the knotless 2.6mm FiberTak. So we're going to drill here. And when we insert this anchor we will by hand ensure that we have the anchor started into the pilot hole. And then we'll gently tap it with a mallet. So the backside of the guide will go flush with the handle of the inserter. And you just pull straight back after you've. Gotten the suture undone. And I just do a gentle pull not to try and deform the anchor, but just to make sure that we're well seated in the bone. So now we've established our are proximal posterolateral portal to insert our posterior anchors. So we've placed our most superior anterior anchor and our most inferior posterior anchor. And now we will convert these anchors creating a compression bridge configuration. So we'll take a loop grasper. And what we have to do here is we're trying to take this stitch here and take it to that anchor and that blue stitch there and bring it to this anchor. So what I like to do is I'll take the loop Grasper push the suture somewhat into the field. I'll grab the round stitch here and I'll run over. And I will basically grab the blue stitch here. And pull these out through the anterior lateral portal. And then we'll come back in through our posterior portal, grab our round stitch here and move forward. And grab our blue stitch. Carefully watching the SutureTape down here to make sure that the conversion stitch doesn't unload itself. And now we're going to convert our posterior stitch by converting it through the looped shuttle. We're finishing the conversion. We're sequentially tensioning each limb of the compression. Suturebridge. So we now have a nice tensioned bridge from anterior to posterior. And this is one limb of our x. So now we've placed our other two anchors to create the create the second limb of the X of the two row compression construct. We'll come in with our loop Grasper. And just like we did the first time, we'll grab our round suture and come posteriorly and grab our blue repair stitch. And we'll come back in our posterior portal and grab our posterior round conversion stitch. And then come to the anterior inferior anchor and grab its appropriate repair suture. And then just like in the first limb, we'll convert the knotless mechanism and convert loosely so that we don't over tension one limb of the compression bridge and then sequentially tension that creating a two row compression bridge in an X configuration. So this is our final construct. After we've converted two pairs of the 2.6 Knotless FiberTak creating a x shaped two row compression bridge. You can see here we've got our anterior superior anchor, our anterior inferior anchor with our posterior superior anchor and our posterior inferior anchor. And as our assistant externally rotates the leg, you can see as the gluteus medius minimus complex comes under tension, you can see this configuration remains taut and provides excellent compression of the partial thickness gluteus medius tendon tear.

Endoscopic Double-Row Gluteus Medius Repair Using the Gluteus Medius Repair System

Sanj Kakar, MD (Rochester, MN), shares a surgical pearl for using the NanoNeedle™ scope 2.0 to access the thumb CMC joint.

SpeedPearl: Accessing the Thumb CMC Joint With the NanoNeedle™ Scope 2.0

Speaker  Accurate diagnosis and assessment of the articular surface of the thumb CMC joint is particularly important, for example, in fractures and when managing thumb CMC arthritis. However, this joint is tight. Given its complex anatomy, and so this is perfect for the nanoneedle scope given its lightweight, small and flexible design. The Nanoneedle allows for safe entry into the thumb CMC joint. I typically create the one new portal first and to provide greater working space, the portal is created next.

SpeedPearl: Accessing the Thumb CMC Joint With the NanoNeedle™ Scope 2.0

Seth I. Gasser, MD (Tampa, FL), shares his firsthand experience with the Synergy Power™ system—highlighting how it streamlines workflow within a facility and why it is his preferred powered instrument solution in the OR.

Dr. Seth I. Gasser Surgeon Testimonial: Synergy Power™ System

Speaker  Energy. Power has really changed the way our team works and functions. It's streamlined the work process, including setup times and surgical times with just two hand pieces. It covers our broad range of needs throughout any procedure. It's reliable. Powerful. Versatile. The frequent changes required often during surgery are quick and easy, with a unique design of the hand pieces. It's very easy for the scrub tech to make a quick change. I don't worry about them having difficulty, and my focus is really on the surgery and the patient because I'm confident that the equipment will work as it's supposed to. It provides a balance of comfort and performance. It has a lighter feel. And it's the kind of comfort that really adds up over the course of long, difficult cases. Arthrex has been a leader and innovator as long as I've been in practice over the past 33 years. They've answered all of our questions, guided our setups, trained the staff, and really made sure everything ran smoothly before we started. And this is just another example of how Arthrex has made it easier for me as a surgeon to treat my patients better.

Dr. Seth I. Gasser Surgeon Testimonial: Synergy Power™ System

John Zvijac, MD (Miami, FL), demonstrates the use of the NanoNeedle™ scope 2.0 and the PassPort Button™ cannula with auxiliary lumen for Nano shoulder arthroscopy labral repairs.

Labral Repair Using the NanoNeedle™ Scope 2.0 and the PassPort Button™ Cannula With Auxiliary Lumen

Speaker  Hi, I'm John from Miami, Florida, and today we're showcasing a label repair technique using the Nanoneedle scope 2.0 and the accessory Lumen Passport. This setup allows for ultra minimally invasive access and enhanced maneuverability. We've already established our portals, and the accessory Lumen Passport is positioned to facilitate suture management and instrument passage. You'll see how this design improves efficiency and flexibility during the repair. Here is what the accessory Lumen Passport looks like. We have a center hole for instrumentation, and then there is an accessory lumen, which allows for passage of a multitude of micro instruments for suture management. Here we see the nanoneedle scope in the posterior shoulder portal and the accessory passport lumen anteriorly in a rotator cuff interval. A little pro tip the accessory portal. If you can leave this inferiorly or posteriorly, it makes it a little bit easier for suture management. It's not that big of a deal. You can always put it in any position, but that's a little pro tip to help as you're moving this along. You can see the soft tissue bankart lesion that's occurred. This is the labrum all the way down. And we're well past the 6:00 position to allow for bringing the capsule both superiorly and laterally onto the articular surface. The labrum often falls not only medially but inferiorly while you're doing these type of surgeries. Speaker  So it's important to free all of this up for proper mobilization and tensioning. We'll be repairing this labral tear with the 1.8mm knotless fiber tack anchor. This is being done through the central lumen of our passport. And now we're going to pass the suture retriever through the accessory portal in our passport. You can see it coming through, and we can easily pass our stitch with the use of a scorpion through our central portal. And now we're going to just easily shuttle our loop stitch through our center portal. And now we're ready for shuttling a repair stitch. Keeping very nice suture management, preventing entanglement of the stitches intra articularly. We're going to take this stitch out through our center hole to allow for final cutting of the stitch. Here we're using the flush cutter, and we can just bring this down to central portal. And we can cut our stitch flush. And we're ready for the next stitch. The repair is completed with precise suture placement and minimal disruption to the surrounding tissue. The accessory Lumen Passport enhances suture management and expands our instrument options for suture passing during a label repair. Combined with the Nanoneedle scope 2.0, we're moving closer to an ideal solution for the ultra minimally invasive arthroscopy.

Labral Repair Using the NanoNeedle™ Scope 2.0 and the PassPort Button™ Cannula With Auxiliary Lumen

Sanj Kakar, MD (Rochester, MN), shares how the NanoNeedle™ scope 2.0 can aid in visualization during wrist arthroscopy procedures.

SpeedPearl: DRUJ Arthroscopy Using the NanoNeedle™ Scope 2.0

Speaker  The trampoline hook and suction test provide an indirect assessment to the foveal insertion of the Tfcc, which is the most important static stabilizer of the Druj. Given how tight the DJ is, the Nanoneedle provides an ideal indication for its use to examine this space and the Foveal insertion of the Tfcc. Using the percutaneous kit, you can access the DJ in a safe and efficient manner.

SpeedPearl: DRUJ Arthroscopy Using the NanoNeedle™ Scope 2.0

At the Orthopedic Technology and Innovation Forum, John J. Christoforetti, MD (Bethesda, MD), and Benjamin G. Domb, MD (Chicago, IL), review the evolution and application of knotless all-suture anchor technology in hip arthroscopy, highlighting its advantages in reproducibility, safety, and adaptability to the anatomical constraints of the hip joint.

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Femoroacetabular Impingement (FAI) and Labral Tears: Literature Review on All-Suture Anchor Outcomes in Hip Arthroscopy

OrthoPedia: Femoroacetabular Impingement (FAI) and Labral Tears: Literature Review on All-Suture Anchor Outcomes in Hip Arthroscopy

The Arthrex ElbowLOC® positioner is a modular, upper extremity positioner that gives the surgeon the choice of supine, lateral, or supine-suspended positioning for elbow surgery, as well as a wrist traction device for wrist and hand arthroscopy. The ElbowLOC positioner is easy to use and set up, and housed in a space-saving single autoclavable tray.

The Arthrex ElbowLOC® Elbow and Wrist Positioner

The Arthrex ElbowLOC® Elbow and Wrist Positioner

The Arthrex Graft Gun features an optimized design for enhanced visualization of graft delivery during minimally invasive and tubular spine surgeries. It is validated to deliver 100% autograft chips.1
Reference
1. Arthrex, Inc. Data on file (APT-1022220). Naples, FL; 2025.

Arthrex Graft Gun

Arthrex Graft Gun

The MaxForce™ MTP fusion system features a unique gear mechanism along the plate, allowing for controlled, dialed-in compression across the joint. Featuring 18 different plate options of varying sizes and curvatures for primary and revision cases and multiple Arthrex plating-screw and cross-screw options to best address patient needs and anatomy, the MaxForce MTP fusion system provides a comprehensive solution for 1st MTP arthrodesis.

MaxForce™ MTP Plating System Features and Benefits Animation

MaxForce™ MTP Plating System Features and Benefits Animation

Julie Bishop, MD (Columbus, OH), demonstrates the innovative bone block cerclage surgical technique for securing a distal tibia allograft to the anterior glenoid for treatment of critical glenoid bone loss. This subscapularis-sparing arthroscopic cadaveric demonstration shows the procedural steps and technical pearls for safe and reproducible metal-free fixation of the bone graft using interconnected FiberTape® cerclage sutures.

Bone Block Cerclage With Distal Tibia Allograft Surgical Technique

Bone Block Cerclage With Distal Tibia Allograft Surgical Technique

The BioACL™ technique augments ACL reconstruction with an unmatched combination of the patient’s own biology, the highest-quality biologics, and the proven technology of the QuadLink™ technique with the InternalBrace™ procedure to maximize healing potential.&nbsp;
 
The InternalBrace surgical technique is intended only to augment the primary repair/reconstruction by expanding the area of tissue approximation during the healing period and is not intended as a replacement for the native ligament. The InternalBrace technique is for use during soft tissue-to-bone fixation procedures and is not cleared for bone-to-bone fixation.

BioACL™ Technique Animation

The bioassay technique enhances ACL reconstruction by integrating next generation Orthobiologics to improve functional outcomes and reduce tunnel widening. Begin by performing a bone marrow aspiration from the proximal tibia, which will be processed using the Angel system. The Angel system uses proprietary 3D sensor technology to develop a customized, patient specific formulation of CRP from BMA. Prepare for Autograft bone collection by connecting the Graphnet device to suction and an arthroscopic shaver. Identify the desired femoral tunnel location and advance the flip cutter three reamer. Introduce the arthroscopic shaver with the graphnet tissue collector attached into the joint and ream the femoral socket while collecting bone debris, The autologous bone debris will be collected in the graphnet sterile chamber. This autologous tissue is highly viable, demonstrating osteogenic significant capacity. Transfer the collected autogenous bone to a sterile dish and add five cc of pure demineralized bone matrix. Titrate three cc of c PRP from BMA prepared with the angel system into the dish. The bio composite mixture is complete and ready for delivery. On the back table, prepare the quad link ACL graft. Elongate the femoral tightrope to ensure the quad link ACL graft sits outside the joint after passing the femoral tightrope button. This positioning allows clear visualization of tunnel fill. The tightrope two implant is preloaded with fiber tape. Suture for the internal brace technique. Begin ACL graft passage by pulling in the femoral tightrope button through the socket and flipping onto the cortex with the elongated femoral tightrope. The quad link ACL graft should be sitting outside the joint from the medial portal, insert the delivery cannula preloaded with the ACL composite and completely fill the femoral tunnel, then move to the lateral portal and deliver the composite into the tibial tunnel. The bio composite graft compresses around the quad link ACL graft. Fully filling both tunnels with this composite has demonstrated a reduction in tunnel widening. Post reconstruction. Fully seat the quad link ACL graft into both femoral and tibial tunnels. Complete internal brace. Final fixation in full extension. After cycling the knee several times, complete femoral and tibial tightrope. Final tensioning.

BioACL™ Technique Animation

The Arthrex Knotless 1.8 FiberTak® soft anchor is our smallest knotless anchor option. This animation demonstrates the unique tensionable knotless technique for arthroscopic glenohumeral joint instability. With a curved guide and 1.8 mm flexible drill, use the Knotless FiberTak soft anchor to create a small, low-profile knotless repair.

Shoulder Labral Repair With the 1.8 Knotless FiberTak® Soft Anchor

The Arthrex knotless FiberTak soft suture anchor is designed with a unique tension able knotless technology, allowing the user the ability to control and tension the repair under direct visualization. A curved guide is introduced through a cannula. After locating the position on the bone surface. A flexible 1.8mm drill is introduced to create the bone socket, leaving the guide in place. The knotless FiberTak anchor is inserted and impacted until the handle is flush with the guide. Remove the handle and drill guide, leaving the number two repair suture and two shuttling suture. Set the anchor by grasping all suture limbs and pull at a slow, consistent pace until the anchor is firmly set in bone. Retrieve the repair suture through the anterior-superior cannula with a suture retriever. Using a QuickPass SutureLasso, pass a nitinol wire loop through the labrum. Retrieve the wire loop and insert the repair suture through the wire loop. The wire and suture are retracted back to the tip of the lasso and shuttled through the tissue. Retrieve the repair suture and the looped end of the two shuttling suture. Load the repair suture through the suture loop. Fold the repair suture limb at the indicator mark on the suture. Pull the tape end of the shuttling suture to shuttle the repair suture. Use repeated light tugs to pass the repair suture through the knotless mechanism. Continue to tension the repair suture until the desired repair is achieved. The suture tail is cut flush, creating a secure, low profile knotless repair.

Shoulder Labral Repair With the 1.8 Knotless FiberTak® Soft Anchor

At the Orthopedic Technology and Innovation Forum, Paul Brady, MD (Knoxville, TN), discusses key diagnostic and surgical principles for managing subscapularis tears and associated biceps pathology, emphasizing improved visualization techniques, knotless anchor repair methods, and strategies to optimize healing.

Managing the Subscapularis and Biceps Tendon

OrthoPedia: Managing the Subscapularis and Biceps Tendon

Rachel M. Frank, MD (Denver, CO), demonstrates the Synergy Power™ system.

Synergy Power™ System Product Demonstration

I'm Doctor Rachel Frank, a sports medicine and shoulder surgeon from the University of Colorado, and I would like to provide an overview of the Synergy Power system. This system was designed and developed in-house by Arthrex Product Development engineers, and is assembled at the manufacturing facility in South Carolina. I'm excited to walk you through the system and my favorite features of Synergy Power. The Synergy Power system is a medium and large bone system comprised of two handpieces, a dual trigger rotary drill, and a dedicated sagittal saw. These two handpieces are designed to cover a wide range of orthopedic applications, including sports arthroplasty and trauma procedures. Both Handpieces are ergonomic, lightweight, and durable, making them easy to use and comfortable for all hand sizes, even during long and complex cases. My favorite feature of the drill is the twist collet mechanism. This design is intuitive and allows for attachments to be quickly changed during a case. This feature saves time in the O.R., which increases our efficiency and creates a smoother experience not only for me as the surgeon, but also for the staff. Synergy power includes a comprehensive attachments portfolio for all drilling, reaming, sawing, and burring needs. The system will offer keyed and hybrid drill chucks and three different sized wire and pin drivers for optimal wire or pin retention. With the three different sizes clearly labeled S, M, and L, one features that you no longer have to adjust the attachment to accommodate your pin. So for example, here we have the medium attachment for the wire. Pin driver easily pops in and you can see that this tells you exactly what size that you're able to use in terms of your K wires. And for example, we'll place a two for k wire into the attachment. And that's all you need to do. And if I move around or the scrub nurse or scrub techs handing me the drill, I don't have to worry about the pin falling out, getting lost on the floor and having to scramble for another pin or another wire. We'll take the pin out when we're done and say we want to. Now put in a smaller pen, simply use the twist mechanism. And now we're going to use the smaller attachment. And we can see it's clearly labeled with an S. Easy to pop in. And we'll take a smaller wire in this case. And again as long as it's within the size that this particular attachment allows which is very clearly labeled, you no longer have to worry about where your pins or where your wires are going. And this makes it so much easier for both you and whoever's handing you the instruments. There are also two attachments micro, sagittal and reciprocating for making smaller cuts. Various other attachments along with several attachments, including a Hudson modified Trinkle reamer. The drill and ream functionalities are built into the attachments, so I don't have to switch between drill and ream modes during a case, and in general, I don't have to use as many handpieces when operating. Synergy power is all about providing greater ease of use, flexibility and ultimately cost savings. Now moving on to the sagittal saw. This handpiece is intended to be used for heavy duty cutting, and my favorite feature is the open hub design. No more blind insertion, as this design allows for easy visualization and confirmation of blade placement. As you can see here. Take the blade, push the button, insert it and done. Very easy. You can see exactly what you're looking at, and you don't have to guess that the blade is fixed. In addition, this ensures that the area has been properly cleaned after undergoing sterilization because you can see into every nook and cranny quite easily. The SOC features an indexing head that rotates every 45 degrees. Offering eight different cutting positions, and comes with a wide variety of large sagittal blades to meet all sawing needs and preferences. Next, let's discuss the Synergy Power battery packs and charger. The battery packs are sterilizable and offered in both a small and large size. Small for light duty procedures and large for heavy duty procedures. The charger has a simple user interface to easily determine the state of charge and offers fast charging. Charging a small battery pack in up to 30 minutes, and charging a large battery pack in about 120 minutes. One of the most unique features of Synergy Power is that this is a modular system with two handpieces. It has everything you need, but takes up so much less space than you're used to. That's better for your surgery center, better for speed, better for your entire team. This system is going to save money and be more efficient, which is going to make you as the surgeon and your team at the surgical center much more happy and ideally provide cost savings to the entire system. Finally, Synergy Power, of course, fits in nicely with Arthrex synergy family of products. Overall, Synergy Power is a powerful, versatile, and reliable powered instrument system, and I encourage you to experience synergy power as soon as possible.

Synergy Power™ System Product Demonstration

This animation demonstrates unicondylar knee resurfacing using the iBalance® UKA system, which helps improve operative efficiency due to the expanded flexibility provided by the new adjustable spacer block.

iBalance® UKA Technique

iBalance® UKA Technique

What's NewMAY 14

Endoscopic Double-Row Gluteus Medius Repair Using the Gluteus Medius Repair System

What’s New This Week and Prior

MAY 13

SpeedPearl: Accessing the Thumb CMC Joint With the NanoNeedle™ Scope 2.0

MAY 12

Dr. Seth I. Gasser Surgeon Testimonial: Synergy Power™ System

MAY 11

Labral Repair Using the NanoNeedle™ Scope 2.0 and the PassPort Button™ Cannula With Auxiliary Lumen

MAY 10

SpeedPearl: DRUJ Arthroscopy Using the NanoNeedle™ Scope 2.0

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