Indirect arthroscopic rotator interval repair.

Repair of the capsular rotator interval has become a successful adjunct to arthroscopic procedures that address glenohumeral instability. This technical note presents a procedure that allows imbrication of the rotator interval in an indirect fashion regardless of pre-existing arthroscopic portals. A monofilament suture is passed percutaneously using a No.18-gauge spinal needle through the inferior portion of the rotator interval capsule. A soft tissue penetrator is passed through the anterior superior portal to retrieve the suture through the superior portion of the rotator interval capsule. A braided suture is then shuttled in the standard fashion. An arthroscopic knot pusher is placed on the inferior limb of the suture and drives this limb below the deltoid and anterior to the capsule to join the second limb for extracapsular fixation. The technique also provides for direct arthroscopic visualization of the repair and does not necessitate entry into the subacromial space. This is a reproducible procedure that allows efficient repair of the rotator interval.