Arthrex Labral Scorpion for Anterior Cruciate Ligament Repair: A Novel Application for this Instrument: Case Report

Introduction: The arthrex labral scorpion suture passer, which is normally used in shoulder surgery for labral repair, is a useful tool to aid in anterior cruciate ligament (ACL) repair techniques. This technique greatly assists anatomic repair and stabilization, and allows the surgeon to complete the operation when there is limited repair instrumentation available, or the surgeon needs better access to the femoral stump. We present a case of the use of the shoulder arthrex labral scorpion used for knee ACL repair technique, which, to our knowledge, has not been reported, utilized for arthroscopic ACL mid-substance repair in a child. Case Report: This case report presents a 12-year-old female with a mid-substance ACL tear following a valgus injury to the right knee following collision with an opponent’s leg while playing basketball. She was initially evaluated by the coaching staff and was discharged home, where she received ace wrap and crutches. The family requested follow-up with our practice several days later and requested seeing the senior author who performed ACL reconstruction on her biological mother and father. The family requested ACL repair to treat this mid-substance tear. Due to a narrow intercondylar width, an arthrex labral scorpion shoulder suture passer was essential for the ACL repair technique to access the limited recess of the femoral stump in the intercondylar notch and accomplish successful repair. Conclusion: The arthrex labral scorpion suture passer for ACL repair techniques using the smaller and more narrow tip compared to the arthrex knee scorpion greatly increases the ability to successfully place suture in the proximal femoral stump secondary to differences in sizes of the femoral stump, different types of ACL tears, or in our case limited access secondary to a child with smaller bones and more narrow intercondylar distance. Keywords: Anterior cruciate ligament, anterior cruciate ligament repair, arthrex labral scorpion, AR-13998QL, femoral stump, arthrex knee scorpion, AR-12990.