Arthroscopic Subdeltoid Humeroplasty in the Beach-Chair Position for Reverse Hill-Sachs Lesions

Reverse Hill-Sachs lesions (HSLs) often involve a greater percentage of the humeral head articular surface than posterior HSLs and frequently require surgical treatment in the setting of posterior shoulder instability. Multiple techniques have been described to treat these lesions depending on their size, acuity, and location. The (modified) McLaughlin procedure is widely used to treat smaller engaging lesions, whereas larger lesions involving a greater percentage of the humeral head articular surface require anatomic disimpaction, termed "humeroplasty." Humeroplasty is traditionally performed via an open approach. This technical note describes an arthroscopic subdeltoid humeroplasty technique for the reduction and fixation of reverse HSLs in the beach-chair position.