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Hill sachs

Matthew J Kraeutler, Eric C McCarty, John W Belk, Brian R Wolf, Carolyn M Hettrich, Shannon F Ortiz, Jonathan T Bravman, Keith M Baumgarten, Julie Y Bishop, Matthew J Bollier, Robert H Brophy, James L Carey, James E Carpenter, Charlie L Cox, Brian T Feeley, John A Grant, Grant L Jones, John E Kuhn, John D Kelly, C Benjamin Ma, Robert G Marx, Bruce S Miller, Brian J Sennett, Matthew V Smith, Rick W Wright, Alan L Zhang
BACKGROUND: Shoulder instability is a common diagnosis among patients undergoing shoulder surgery. PURPOSE: To perform a descriptive analysis of patients undergoing surgery for shoulder instability through a large multicenter consortium. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: All patients undergoing surgery for shoulder instability who were enrolled in the MOON Shoulder Instability Study were included...
March 1, 2018: American Journal of Sports Medicine
Brian J Kelly, Larry D Field
Posterior shoulder instability occurs less often than anterior shoulder instability but is increasingly recognized as a relatively common condition. The reverse Hill-Sachs lesion is present in some patients with posterior instability and is best described as an impaction fracture of the anterior humeral head. These reverse Hill-Sachs lesions can predispose the patient to recurrent instability events and may need to be addressed directly at the time of surgery. Multiple open and arthroscopic procedures have been described to transfer bone or soft tissue structures into this reverse Hill-Sachs defect...
October 2017: Arthroscopy Techniques
David Saliken, Vincent Lavoué, Christophe Trojani, Jean-François Gonzalez, Pascal Boileau
Patients presenting with recurrent shoulder instability and bipolar glenohumeral bone loss are at risk of failed standard soft-tissue repair techniques. Even isolated bony-stabilization procedures such as the Latarjet or remplissage technique may not provide sufficient stability in the face of combined bone loss. We use a combined all-arthroscopic remplissage, Latarjet, and Bankart repair for patients with significant combined glenohumeral bone loss and/or in the revision setting. This allows reconstruction of both the Hill-Sachs and glenoid bone defects and repair of the capsulolabral complex in a minimally invasive manner...
October 2017: Arthroscopy Techniques
Paolo Consigliere, Natasha Morrissey, Mohamed Imam, A Ali Narvani
Arthroscopic Bankart repair is now a well-established technique for the treatment of shoulder instability. However, failure rates are considerable when significant bony defects are not addressed. Hill-Sachs lesions, present in the vast majority of those with recurrent anterior instability, when of significant dimension and location, may account for some of these failures. The remplissage procedure involves capsulotenodesis of the posterior capsule and the infraspinatus tendon to fill the Hill-Sachs lesion. "Double-pulley" remplissage is a transtendinous technique that has been described elsewhere and that may simplify the procedure...
October 2017: Arthroscopy Techniques
Jin Tang, Caiqi Xu, Jinzhong Zhao
Recurrent anterior shoulder dislocation often leads to the presence of a Hill-Sachs lesion. A large Hill-Sachs lesion compromises shoulder stability and should be addressed with bone augmentation when it is too deep. Here, we introduce a method of arthroscopic bone grafting of the humeral head for the treatment of a deep Hill-Sachs lesion in patients with anterior shoulder instability. Our indication for this procedure is a deep off-track Hill-Sachs lesion measuring at least 8 mm in depth and 10 mm in width...
October 2017: Arthroscopy Techniques
Mohamed G Morsy
Posterolateral humeral head defects can be large and engage on the anterior glenoid, and they usually contribute to anterior shoulder instability in 40% to 90% of cases.The purpose of this study is to evaluate the results of the largest series of patients who underwent arthroscopic remplissage with Bankart repair for recurrent anterior shoulder instability due to associated Bankart lesions, with large and engaging (> 25% involvement) humeral Hill-Sachs defects (HSDs).A total of 51 patients underwent arthroscopic Bankart repair with remplissage technique for the treatment of recurrent anterior glenohumeral instability with large and medial HSDs...
December 2017: EFORT Open Reviews
Kevin C Wang, Brian R Waterman, Eric J Cotter, Rachel M Frank, Brian J Cole
Isolated, full-thickness articular cartilage lesions of the glenohumeral joint can cause pain, mechanical symptoms, and impaired function. Reports on operative management of these injuries with arthroscopic techniques, such as marrow stimulation, have shown improvement in patient symptoms. In cases where the subchondral bone is involved, osteochondral allograft (OCA) transplantation has shown positive results for contained, focal cartilage defects. The technique for OCA transplantation to treat Hill-Sachs lesions has been reported in detail, and there are multiple case series reporting on the outcomes of OCA used for this purpose...
August 2017: Arthroscopy Techniques
Rob Halle, Jeffery Dolbeer, Donald Goss
A 20-year-old military cadet injured his left shoulder after landing in an abducted and externally rotated arm position while participating in a mandatory obstacle course. Following examination, the individual was taken to the emergency department, where radiographs confirmed an anterior dislocation of the glenohumeral joint and a large Hill-Sachs lesion wedged on the glenoid. Results of noncontrast magnetic resonance imaging and a computed tomography scan confirmed the presence of a large Hill-Sachs lesion...
January 2018: Journal of Orthopaedic and Sports Physical Therapy
A Bah, G M Lateur, B T Kouevidjin, J Bassinga, M Issa, A Jaafar, E Beaudouin
BACKGROUND: The objective of this study was to compare short-term shoulder stability after arthroscopic Bankart repair with remplissage versus the open Latarjet procedure in patients who had chronic anterior shoulder instability with a significant Hill-Sachs lesion. HYPOTHESIS: The dislocation recurrence rate is higher after Bankart repair with remplissage than after open Latarjet. PATIENTS AND METHODS: An observational non-randomised retrospective cohort study was conducted at two surgical centres in patients treated for chronic anterior shoulder instability with a significant Hill-Sachs defect between January 2009 and July 2014...
December 14, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
Kristian Nikolaus Schneider, Benedikt Schliemann, Salomon M Manz, Pranai K Buddhdev, Georg Ahlbäumeri
Introduction: Bilateral shoulder dislocations are rare and a diagnostic as well as a therapeutic challenge. Case Report: We report the case of a 67-year-old male who fell while skiing and suffered a bilateral anterior shoulder dislocation associated with a four-part proximal humerus fracture on the left side and an osseous avulsion of the rotator cuff, a Pulley lesion, and a Hill-Sachs lesion on the right side. In addition, we searched the PubMed database using the terms "bilateral shoulder dislocation" and also "bilateral glenohumeral dislocation"...
September 2017: Journal of Orthopaedic Case Reports
Aishwarya Gulati, Riham Dessouky, Vibhor Wadhwa, Drew Sanders, Avneesh Chhabra
The shoulder is the most frequently dislocated joint in the body due to a larger range of motion and a small area of articulation between the humeral and glenoid surfaces. Traumatic shoulder dislocations, especially those associated with injury to the labroligamentous or bony stabilizers of the joint, lead to further reduction of articular surface contact with resultant glenohumeral instability and recurrent shoulder dislocations. Imaging plays an increasingly important role in the preoperative evaluation of patients with traumatic shoulder instability by evaluating glenohumeral bone loss (uni- or bipolar), assessing soft tissue injuries and identifying patients at risk of postoperative recurrence...
January 1, 2017: Acta Radiologica
J A Rosas-Medina
INTRODUCTION: Glenohumeral dislocation (GHD) is frequent, but traumatic posterior glenohumeral dislocation (TPGHD) is rare, with an incidence of 1-4% of all GHD. The diagnosis is a challenge: sometimes, it can be omitted due to incorrect diagnosis, absence of consideration in the differential diagnosis, suboptimal radiographic evaluation and an absence of characteristic signs and symptoms; missed diagnosis reaches 60-79% and the diagnosis can delay from 24 hours to a year. OBJECTIVE: To transmit previous experiences to provide support for better diagnosing TPGHD, favoring appropriate attention...
July 2017: Acta Ortopédica Mexicana
Anthony Ho, Michael D Kurdziel, Denise M Koueiter, J Michael Wiater
BACKGROUND: The glenoid track concept has been proposed to correlate shoulder stability with bone loss. Accurate assessment of Hill-Sachs lesion size preoperatively may affect surgical planning and postoperative outcomes; however, no measurement method has been universally accepted. This study aimed to assess the accuracy and reliability of measuring Hill-Sachs lesion sizes using 3-dimensional (3D) computed tomography (CT). METHODS: Nine polyurethane humerus bone substitutes were used to create Hill-Sachs lesions of varying sizes with a combination of lesion depth (shallow, intermediate, and deep) and width (small, medium, and large)...
February 2018: Journal of Shoulder and Elbow Surgery
Kenneth M Lin, Evan W James, Elad Spitzer, Peter D Fabricant
PURPOSE OF REVIEW: The purpose of this review is to discuss the epidemiology, pathoanatomy, diagnosis, and clinical management of pediatric and adolescent patients following a first-time shoulder dislocation. RECENT FINDINGS: Shoulder instability is becoming increasingly common as pediatric and adolescent patients engage in earlier organized sports competition. Recommended treatment following a first-time glenohumeral dislocation event in adolescents depends on several factors, but surgical stabilization is becoming more frequently performed...
November 11, 2017: Current Opinion in Pediatrics
Markus Guehring, Simon Lambert, Ulrich Stoeckle, Patrick Ziegler
BACKGROUND: The current study describes several surgical techniques for the treatment of the reverse Hill - Sachs lesion after posterior shoulder dislocation; we also aimed to present long term results followed for a minimum of five years. METHODS: This study is a prospective case series of 17 patients who were treated in our clinic between 2008 and 2011. Patients with a defect size smaller than 25% of the articular surface were treated conservatively. An endoprosthesis of the glenohumeral joint was implanted in patients with a defect size bigger than 40%...
November 13, 2017: BMC Musculoskeletal Disorders
Meriç Çırpar, Birhan Oktaş, Bülent Dağlar
In this article, we report a case of bilateral posterior shoulder instability, having reverse Hill-Sachs lesions of 25 to 50% of the articular surface on the right side, and of 50% on the left side. The defects were anatomically reconstructed after tuberculum minus osteotomy by elevation of the articular surface and buttressing with raft screws without graft usage. Early rehabilitation with pendulum shoulder exercises was started at third postoperative day. At postoperative sixth week, patient had full range of motion without instability and pain...
December 2017: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
M Wellmann, M-F Pastor, T Smith
Posterior shoulder instability has a markedly lower incidence than anterior shoulder instability. It has a wide spectrum of clinical symptom manifestations and the overwhelming number of patients lack a traumatic primary dislocation. In addition to a detailed medical history, a specific clinical examination with the help of standardized provocation tests is essential for the diagnostics. For the detection of structural posterior capsule and labral lesions in cases of chronic courses, magnetic resonance imaging (MRI) should be used with an intra-articular contrast agent...
November 9, 2017: Der Unfallchirurg
Ryan E Breighner, Yoshimi Endo, Gabrielle P Konin, Lawrence V Gulotta, Matthew F Koff, Hollis G Potter
Purpose To determine the intermodality agreement of morphologic grading and clinically relevant quantitative measurements between computed tomography (CT) and zero echo time (ZTE) magnetic resonance (MR) imaging of the shoulder. The primary objective was to demonstrate the clinical applicability of ZTE in osseous shoulder imaging. Materials and Methods Thirty-four patients undergoing standard-of-care (SOC) MR imaging with concomitant CT were enrolled in this institutional review board-approved study. ZTE images were acquired after SOC MR imaging...
November 8, 2017: Radiology
Paolo Baudi, Manuela Rebuzzi, Giovanni Matino, Fabio Catani
Background: Unstable shoulder can occur in different clinical scenarios with a broad spectrum of symptoms and presentations: first-time (or recurrent) traumatic acute shoulder anterior dislocation or chronic anterior instability after repeated dislocations.Imaging in unstable shoulder is fundamental for choosing the right treatment preventing recurrence.The goal of imaging depends on clinical scenario and patient characteristics. Method: Careful selection and evaluation of the imaging procedures is therefore essential to identify, characterize and quantify the lesions...
2017: Open Orthopaedics Journal
Jake A Fox, Anthony Sanchez, Tyler J Zajac, Matthew T Provencher
PURPOSE OF REVIEW: The purpose of this study is to provide an update to the orthopedic field in regard to treatment of the Hill-Sachs lesion and anterior shoulder instability. The review highlights the most current knowledge of epidemiology, clinical evaluation, and surgical methods used to treat Hill-Sachs lesions. It also details the relevant clinical and surgical findings that have been made throughout the literature in the past couple of years. RECENT FINDINGS: The most recent literature covering the Hill-Sachs lesion has focused on the relatively new and unexplored topic of the importance of concomitant injuries while treating a humeral head defect...
December 2017: Current Reviews in Musculoskeletal Medicine
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