A modification of the McLaughlin procedure for persistent posterior shoulder instability: technical note.

Area of Science:

• Orthopedic Surgery
• Shoulder Instability Research
• Biomechanical Repair Techniques

Background:

• Persistent posterior shoulder instability often results from traumatic posterior glenohumeral dislocation.
• Large antero-medial reverse Hill-Sachs lesions complicate treatment, potentially leading to recurrent instability.
• The McLaughlin procedure, involving subscapularis division, is a known surgical option.

Observation:

• A modification of the McLaughlin procedure is described for persistent posterior shoulder instability.
• The technique involves plicating the subscapularis tendon into the reverse Hill-Sachs lesion using suture anchors.
• This approach avoids dividing the subscapularis tendon near its insertion.

Findings:

• The modified technique successfully treated a patient with persistent posterior instability following posterior glenohumeral dislocation.
• Suture anchors were utilized to secure the plicated subscapularis tendon within the humeral head defect.
• This method addresses the large antero-medial reverse Hill-Sachs lesion.

Implications:

• This modified technique offers a potentially less invasive alternative for managing posterior shoulder instability.
• It may preserve subscapularis function compared to the original McLaughlin procedure.
• Further studies are warranted to evaluate the long-term efficacy and broader applicability of this surgical modification.