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Dr. Garcia demonstrates his new low profile posterior labral repair for high level throwing athletes.
Dr. Garcia specializes in complex knee, shoulder and elbow sports surgeries. He has prepared a number of surgical videos below to help patients better understand their procedures. He is frequently updating his surgical video database so check back soon for further updates.
This video demonstrates an advanced arthroscopic technique for a low-profile, completely knotless posterior labral repair. This specialized procedure is tailored specifically for high-level throwing athletes (such as baseball pitchers) suffering from posterior shoulder instability. By using tiny, all-soft-tissue Knotless FiberTack anchors, Dr. Garcia stabilizes the joint while minimizing capsular plication (tightening). This preserves the critical shoulder flexibility needed for high-velocity throwing and eliminates bulky suture knots that can cause internal "catching" or pain.
The procedure is executed through the following clinical steps:
- Visualization & Preparation: With the patient in a lateral position, Dr. Garcia establishes an anterior-superior viewing portal to get a clear view of the back of the shoulder. He mobilizes the torn labral tissue off the bone and uses a curved rasp to abrade the glenoid rim. This creates a raw, bleeding bone bed to optimize biological healing.
- Strategic Anchor Placement: Using a specialized 15-degree curved guide, Dr. Garcia places the soft-tissue anchors along the posterior glenoid rim, starting at the 6 o'clock position. The curved guide is critical because it prevents the instrument from slipping off the flat glenoid bone and allows accurate placement without needing an extra surgical portal in the back of the shoulder.
- Precision Tissue Passing: An arthroscopic suture passer is used to take a secure bite through the labrum and a conservative portion of the joint capsule.
- Knotless Tensioning: To lock the repair, Dr. Garcia pulls the suture limbs through the anchor's integrated self-locking eyelet. He notes a key technical tip: the loop and pull sutures must be managed together out of the cannula to prevent internal tangles. A knot pusher is used to sequentially ratchet the labrum down flush against the bone before the suture tails are cut clean.
The final evaluation shows a perfectly reconstructed labral bumper that blocks the shoulder from slipping backward, providing maximum mechanical stability with a low-profile design that helps athletes safely return to sports.
