CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2019; 54(02): 228-232
DOI: 10.1016/j.rbo.2017.09.009
Technical Note| Nota Técnica
Sociedade Brasileira de Ortopedia e Traumatologia. Published by Thieme Revnter Publicações Ltda Rio de Janeiro, Brazil

Modified Arthroscopic McLaughlin Procedure in the Treatment of Posterior Glenohumeral Instability—Technical Note[*]

Article in several languages: português | English
Tiago Pinheiro Torres
1  Centro Hospitalar de Vila Nova de Gaia, Vila Nova de Gaia, Portugal
2  Casa de Saúde da Boavista, Porto, Portugal
3  Hospital CUF, Porto, Portugal
,
Sara Lima
2  Casa de Saúde da Boavista, Porto, Portugal
3  Hospital CUF, Porto, Portugal
,
Manuel Gutierre
2  Casa de Saúde da Boavista, Porto, Portugal
3  Hospital CUF, Porto, Portugal
4  Centro Hospitalar de São João, Porto, Portugal
› Author Affiliations
Further Information

Publication History

04 July 2017

17 January 2018

Publication Date:
10 May 2019 (online)

Abstract

The diagnosis of and the treatment for traumatic posterior shoulder dislocation are challenging. Some series describe that between 60 and 80% of these lesions are not diagnosed during the first visit to the emergency room. As such, dislocations are frequently found after several days or even weeks, adding complexity to their treatment. Posterior dislocations are usually accompanied by a print fracture on the anterior surface of the humeral head, known as reverse Hill-Sachs injury. This bone defect can “engage” into the posterior glenoid ridge, leading to recurrent instability and progressive joint destruction. The authors describe a modified arthroscopic McLaughlin procedure, which allows filling the bone defect with the upper third of the subscapular tendon, avoiding recurrence of the posterior instability. Next, a posterior Bankart lesion repair is performed along with a tenodesis of the long portion of the bicipital tendon. This technique, in addition of repairing the posterior chondrolabral lesion, creates a remplissage effect, making the repair stronger and representing an optimal procedure for the definitive treatment of recurrent posterior luxation. It is an entirely arthroscopic procedure, avoiding the disadvantages of an open procedure.

* Work developed at the Casa de Saúde da Boavista, Porto, Portugal.