All-Arthroscopic McLaughlin's Procedure in Patients with Reverse Hill-Sachs Lesion Caused by Locked Posterior...

Purpose  This study aims to investigate the clinical and functional outcomes of the all-arthroscopic McLaughlin procedure in a clinical series of patients suffering by neglected locked posterior shoulder dislocation. Methods  A retrospective clinical study based on prospectively collected data was conducted in a single center regarding 10 patients with neglected locked posterior shoulder dislocation and concomitant reverse Hill-Sachs lesion, who were treated with the all-arthroscopic Mclaughlin procedure. The average humeral bone defect was 39 ± 7% according to the preoperative computed tomography evaluation. The mean time of follow-up was 77 ± 16 months (range, 63-104 months). Results  No patient had suffered a new dislocation, whereas all of them were satisfied with the surgical outcome and returned to their previous activities of daily living. External rotation was restored to every patient studied from 0 degrees at the baseline. At the last follow-up, the median external rotation beside the body was 90 degrees (range, 50-90 degrees; p  < 0.01) and the respective measurement at 90 degrees of abduction was 90 degrees (range, 80-90 degrees; p  < 0.01). The active forward flexion was increased ( p  < 0.01), from 60 degrees (range, 30-180 degrees) at the baseline to 180 degrees (range, 160-180 degrees) at the last follow-up and the internal rotation was gained ( p  < 0.01) from the level of buttock (range, lateral thigh-T12) at the baseline to the T11 level (range, T7-L3) at the last follow-up. The median UCLA score was increased from 8 (range, 4-22) to 35 (range, 33-35; p  < 0.01) and the Oxford instability score from 5 (range, 3-16) to 46 (range, 43-48; p  < 0.01), respectively. Conclusion  The arthroscopic McLaughlin procedure in substantial reverse Hills-Sachs lesion caused by locked posterior dislocation leads to excellent clinical and functional results in the long-term follow-up. Level of Evidence  This is a therapeutic study, case series with no comparison group, Level IV.