Arthroscopic Knotless Modified McLaughlin Procedure for Reverse Hill–Sachs Lesions

Posterior shoulder dislocations often are associated with an impression fracture involving the anterior humeral head known as a reverse Hill–Sachs lesion. These injuries can result in significant bone defects that require surgical management to prevent them from engaging the posterior glenoid. We present a modified arthroscopic, knotless McLaughlin procedure (tenodesis of the subscapularis tendon into the bone defect) for the treatment of small-to medium-sized, engaging Hill–Sachs lesions. The knotless fashion aims to eliminate potential problems associated with knot tying, such as knot migration, knot impingement, and chondral abrasion.