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

(hil′saks′)

[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.

Etiology

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.

Symptoms

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.

Treatment

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

Hill,

Harold A., U.S. radiologist, 1901–.

Hill-Sachs lesion - an irregularity seen in the head of the humerus following dislocation of the shoulder.

Sachs,

Maurice D., U.S. radiologist, 1909–.

Hill-Sachs lesion - see under Hill, Harold A

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References in periodicals archive ?

Remplissage is a non-anatomic technique that directly addresses the Hill-Sachs lesion.

Consequently, greater external rotation is required for engagement of the Hill-Sachs lesion.

While this procedure does not directly address the Hill-Sachs lesion, it does restore articular arc length.

Preoperative analysis of the Hill-Sachs lesion in anterior shoulder instability: how to predict engagement of the lesion.

Addressing the Hill-Sachs Lesion: humeral head bone loss and glenohumeral instability

Arthroscopic double-pulley reimplissage technique for engaging Hill-Sachs lesions in anterior shoulder instability repairs.

Current trends in the management of recurrent anterior shoulder instability

In addition, direct bone grafting for large Hill-Sachs lesions with allograft humeral head or femoral head has recently been advocated for "engaging Hill-Sachs lesions" as well.

We report on a small series of cases from 2002-2008 at our institution of anterior glenohumeral instability, with severe bone loss, treated using either open femoral head and humeral head allograft reconstruction of the humeral head for large Hill-Sachs lesions, or open allograft and autograft iliac crest reconstruction of the glenoid rim for severe glenoid bone loss.

Five patients were identified who underwent allograft reconstruction of large Hill-Sachs lesions (1 female and 4 males).

Management of humeral and glenoid bone loss associated with glenohumeral instability: results with anatomical bone grafting

44) The operative procedure to be performed is dependent on the size and location of the Hill-Sachs lesion, the bone quality and quantity of the humeral head, the presence of underlying degenerative changes, the size of the glenoid rim fracture, and the chronicity of the injury.

They concluded that: 1) arthroscopic Bankart repair is comparable to open repair if no "significant" structural bone loss (engaging Hill-Sachs lesion or inverted-pear glenoid) exists; 2) contact athletes without such deficits may be treated with arthroscopic repair without compromising results; 3) the presence of such defects is a relative contraindication to arthroscopic repair; and 4) such defects should be addressed with coracoid transfer to increase stability.

Bone grafting may be indicated in cases of instability associated with a Hill-Sachs lesion involving 20% to 45% of the articular arc (36) or in cases of glenoid rim loss greater than 20%.

A posteromedial Hill-Sachs lesion tends to engage the anterior glenoid rim with less external rotation than more posterolateral lesions.