Arthroscopic Modified McLaughlin Procedure and Posterior Labral Repair in the Lateral Decubitus Position

Area of Science:

• Orthopedic Surgery
• Arthroscopy
• Shoulder Reconstruction

Background:

• Traumatic posterior shoulder dislocations often involve posterior labral tears and reverse Hill-Sachs lesions (RHSLs) on the anterior humeral head.
• These defects can cause instability by engaging the posterior glenoid rim, potentially necessitating surgical repair.
• Existing open surgical techniques vary based on RHSL size, including subscapularis tendon transfer or allograft reconstruction.

Purpose of the Study:

• To present an all-arthroscopic technique for managing moderately sized reverse Hill-Sachs lesions (RHSLs) concomitant with posterior labral tears.
• To describe a surgical approach that addresses both the labral pathology and the humeral head defect simultaneously.

Main Methods:

• An all-arthroscopic technique was performed in the lateral decubitus position.
• The procedure involved concomitant repair of the posterior labral tear.
• A reverse remplissage, also known as an arthroscopic modified McLaughlin procedure, was utilized to transfer the subscapularis tendon into the RHSL.

Main Results:

• The study presents a minimally invasive, all-arthroscopic solution for a specific type of shoulder instability.
• The described technique addresses both the posterior labral tear and the reverse Hill-Sachs lesion.
• This approach offers an alternative to traditional open surgeries for moderately sized defects.

Conclusions:

• The described all-arthroscopic technique offers a viable surgical option for treating posterior labral tears and reverse Hill-Sachs lesions.
• This minimally invasive approach may provide an alternative to open procedures for specific indications.
• Concomitant arthroscopic repair of the labrum and reverse remplissage is feasible for managing these complex shoulder injuries.