A Novel Arthroscopic Mclaughlin Procedure for Rotator Cuff Repair in Patients with the Osteoporotic Major Tubercle: A Minimum of 6 Years Follow Up

0bjective: To evaluate the outcomes of rotator cuff tear repair with arthroscopic McLaughlin suture in patients with major tubercle osteoporosis. Methods: 35 patients with rotator cuff tear were treated by arthroscopic McLaughlin suture from April 2007 to January 2009. The mean age of the cases was 63.8 (48 to 78) years. All of the cases were full thickness tear ranging 15 mm to 35 mm. The AP and the supraspinatus outlet projection of the X-rays were obtained before surgery. 11 patients had undergone MR examinations and 21 cases had MRA. All the patients underwent acromioplasty. 18 cases were treated by 1, and 17 cases were treated by 2 arthroscopic McLaughlin sutures. UCLA scoring system and MRI scan was adopted to evaluate shoulder function before operation and at the final follow-up time. Results: 32 cases were followed up with a mean postoperative time of 7.8 years. The average UCLA score was improved from a preoperative rating of 13.3 to a postoperative rating of 33.1. The mean pain score was 3.2 vs. 8.7, for pre- vs. post-operation, the function score was 5.3 vs. 9.1, the mean forward flexion score was 3.5 vs. 4.9, the mean forward flexion strength was 4.0 vs. 4.8. The results were 22 excellent, 8 good, 2 fair. The complications encountered included development of major tubercle broken during operation in 1 case; retear in one case and 3 cases with frozen shoulder symptoms. Conclusion: Arthroscopic McLaughlin suture fixation can provide a micro invasive, firm fixation and a large area for rotator cuff healing, without any anchor related complications. The technique is especially valid for the patient with osteoporosis. Clinical relevance: Arthroscopic McLaughlin suture technique in the treatment of rotator cuff tear with major tubercle osteoporosis can give a fine substrate for the bone-tendon ultimate integration, it’s firm, saveable, and can be a widely used technique especially the patients with humeral head osteoporosis. Level of Evidence: Level IV, therapy.