Hill-Sachs lesion

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Related to Hill-Sachs lesion: reverse Hill Sachs lesion, Bankart lesion

Hill-Sachs defect

an irregularity seen in the head of the humerus following anterior dislocation of the shoulder; caused by impaction of posterolateral portion of the head of the humerus against the anterior edge of the glenoid.
Synonym(s): Hill-Sachs lesion

Hill-Sachs le·sion

(hil saks lē'zhŭn)
An articular cartilage defect on the posterior aspect of the humeral head, often caused by injury to the humeral head by the rim of the glenoid fossa after anterior glenohumeral dislocation.

Hill-Sachs lesion

[Harold A. Hill, U.S. radiologist, b. 1901; Maurice Sachs, U.S. radiologist, b. 1909]
An osteochondral fracture of the posterolateral humeral head that occurs following an anterior dislocation of the glenohumeral joint. The lesion involves the cartilage of the humeral head, causing instability that may predispose the individual to subsequent anterior glenohumeral dislocations.


A Hill-Sachs lesion occurs in about 40% of all first-time anterior dislocations and up to 80% of recurrent dislocations. The relative size of the lesion, as determined through an arthroscope or diagnostic imaging, can be used to ascertain the relative magnitude of the original dislocation.


Although many Hill-Sachs lesions are asymptomatic, pain may arise from the posterolateral humeral head when the glenohumeral joint is abducted to 90°, and passive external rotation is applied.


Surgical repair may be needed to increase anterior stability of the glenohumeral joint.


Harold A., U.S. radiologist, 1901–.
Hill-Sachs lesion - an irregularity seen in the head of the humerus following dislocation of the shoulder.


Maurice D., U.S. radiologist, 1909–.
Hill-Sachs lesion - see under Hill, Harold A
References in periodicals archive ?
Rotational humeral osteotomy for recurrent anterior dislocation of the shoulder associated with a large Hill-Sachs lesion.
Caption: Figure 1 Axillary radiograph showing Hill-Sachs lesion in the posterolateral humeral head.
Caption: Figure 3 Location of the Hill-Sachs lesion within the glenoid track (A) or medial to the glenoid track (B) will determine whether the lesion is engaging and therefore prone to instability.
Measurement is determined on CT as the angle between the axis of the deepest groove of the Hill-Sachs Lesion and the longitudinal axis of the humeral shaft.
Caption: Figure 5 Humeral head allograft sized matched to Hill-Sachs lesion to restore articular arc and prevent engagement.
As previously noted, the internal rotation view is especially helpful in identifying Hill-Sachs lesions.
23) Patients with engaging Hill-Sachs lesions or glenoid bone loss may complain of pain, crepitation, a sensation of catching, or gross instability as the defect is encountered.
20,44) With Hill-Sachs lesions involving less than 20% of the articular surface or glenoid bone loss of less than 20%, surgery to restore soft tissue integrity by capsulolabral (Bankart) repair is generally sufficient; thus obviating the need to address the osseous injuries.
This procedure is indicated for large (up to 45%) Hill-Sachs lesions in younger patients for whom prosthetic replacement is less desirable, particularly after other surgical treatments have failed to adequately address instability.
Rotational humeral osteotomy to address large Hill-Sachs lesions associated with recurrent anterior dislocation was first described in 1969.
Prosthetic replacement is recommended for patients with Hill-Sachs lesions more than 45% of the articular surface, severe cartilage damage, marked osteopenia, or underlying degenerative changes.