Arthroscopic Reverse Remplissage for Posterior Instability

Lavender, Chad; Hanzlik, Shane; Pearson, Sara E.; Caldwell, Paul E.

doi:10.1016/j.eats.2015.09.005

Cited by 28 publications

(26 citation statements)

References 9 publications

(9 reference statements)

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“…However, we found only level-V papers published (without any clinical outcome) regarding this arthroscopic modified McLaughlin's procedure. 12,[15][16][17] The present study is the first to investigate the clinical and functional results of the arthroscopic modified McLaughlin procedure. Particularly, all the clinical subjective scores (UCLA and Oxford instability score) used for the follow-up assessment of our patients were found statistically improved.…”

Section: Discussionmentioning

confidence: 94%

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

Brilakis

Malahias

Patramani

et al. 2019

Joints

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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.

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Section: Discussionmentioning

confidence: 94%

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

Brilakis

Malahias

Patramani

et al. 2019

Joints

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“… 2 Additionally, Lavender et al. 16 described a technique for arthroscopic reverse remplissage using multiple suture anchors. Despite the paucity of outcomes data regarding such procedures, there are many potential advantages of arthroscopic techniques.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic Management of Locked Posterior Shoulder Dislocations

Byram

Field

2018

Arthroscopy Techniques

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Locked posterior shoulder dislocations occur relatively uncommonly but pose aunique array of challenges for the treating surgeon. Posterior labral detachments and capsular damage along with reverse Hill-Sachs lesions are commonly present in these patients and must often be addressed at the time of surgical intervention. Multiple open and arthroscopic procedures that address these pathologic lesions have been described. Arthroscopic shoulder stabilization for patients with locked posterior shoulder dislocations for whom significant posterior instability and subluxation persist following closed reduction is described. A specific patient who underwent both arthroscopic posterior stabilization and supplemental advancement of the subscapularis into the reverse Hill-Sachs defect serves as a case example of this technique.

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“… 19 Since this original description, several similar nonanatomic techniques have been proposed to address these defects in both open and arthroscopic fashion including the remplissage procedure by placing soft tissue structures into the impaction, which act to fill the defect and limit engagement against the glenoid. 20 , 21 , 22 …”

Section: Discussionmentioning

confidence: 99%

Concomitant Reverse Hill-Sachs Lesion and Posterior Humeral Avulsion of the Glenohumeral Ligament: Treatment With Fresh Talus Osteochondral Allograft and Arthroscopic Posterior Humeral Avulsion of the Glenohumeral Ligament and Labrum Repair

Mitchell

Vap

Sánchez

et al. 2017

Arthroscopy Techniques

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Chronic posterior glenohumeral joint instability can be a challenging clinical entity for patients and surgeons alike. In the setting of a posterior dislocation, a large anterior humeral impaction injury (reverse Hill-Sachs [HS]) may occur, leading to engagement of the humerus with the posterior glenoid bone, especially during internal rotation of the joint. A reverse HS is especially debilitating because of the significant portion of affected humeral head cartilage, and is made worse in the setting of ligamentous disruption such as a posterior humeral avulsion of the glenohumeral ligament (HAGL) lesions. Although several nonanatomic procedures to address these defects have been previously described, recent interest in anatomic reconstructions capable of restoring the cartilage surface of the humeral head has led to the use of bone grafts (autografts and allografts) to restore the articular contour of the humeral head in conjunction with anatomic repair of associated soft tissue injuries. We present our preferred technique for an anatomic repair of a posterior HAGL lesion in combination with reconstruction of an engaging reverse HS lesion using an unmatched hemitalar allograft.

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Arthroscopic Reverse Remplissage for Posterior Instability

Cited by 28 publications

References 9 publications

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

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

Arthroscopic Management of Locked Posterior Shoulder Dislocations

Concomitant Reverse Hill-Sachs Lesion and Posterior Humeral Avulsion of the Glenohumeral Ligament: Treatment With Fresh Talus Osteochondral Allograft and Arthroscopic Posterior Humeral Avulsion of the Glenohumeral Ligament and Labrum Repair

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