A dislocated shoulder is when the head of the humerus is out of the shoulder joint. It is unknown whether the desired humeral derotation actually is achieved with the weber osteotomy. Arthroscopic bankart repair and open latarjet bone block procedure are widely considered mainstays for surgical treatment of recurrent anterior shoulder instability. Remplissage versus latarjet for engaging hillsachs. Viewing from the posterior portal, the surgeon identifies a large hillsachs lesion. The discard of another lesions balkart lesion, hillsachs lesion and the. Bankart and hillsachs lesions are often associated with anterior shoulder dislocation. In other cases, however, equivalent lesions can be present, as for example, glenoid bony injury bony bankart or periosteal lesions anterior. The bony bankart lesion is new, as evidenced by lack of cortex on the superior part of the fragment, and is presumed to be caused by glenohumeral ligaments pulling the humerus towards the glenoid as the shoulder dislocates, causing a fracture even without significant external forces. Pdf hillsachs lesion is a defect of the posterosuperior aspect of the humeral head that occurs during an episode of instability. Other readers will always be interested in your opinion of the books youve read. Keywords hillsachs lesion, shoulder instability, computed. Any information contained in this pdf file is automatically generated from digital material. Backgroundengaging hillsachs lesions are known to be a risk factor for.
Shoulder arthroscopy and mri techniques georg lajtai. Hillsachs fig 17, bony bankart fig 18,19 and its variants. Arthroscopic repair of a posterior bony bankart lesion. An animated description of two conditions that can occur with a shoulder dislocation and contribute to further shoulder instability. Traumatic glenohumeral bone defects and their relationship to failure of arthroscopic bankart repairs. Download acrobat pdf file 7mb icmje author disclosure forms. The weber derotation osteotomy is an uncommon procedure that typically is reserved for patients with engaging hillsachs defects who have had other surgical treatments for shoulder instability fail. The hill sachs lesion is an osseous defect of the humeral head that is typically associated with anterior shoulder instability. A hill sachs lesion is a posteriorsuperior bony defect of the humeral head.
Assessment of coincidence and defect sizes in bankart and hill. The choice between these procedures depends mainly on surgeon preference or training rather than published evidence. Patients who underwent osteochondral allograft transplantation for large hillsachs lesions were identified. The glenoid track is a unique biomechanical model that relates both hillsachs and bony bankart lesions to predict shoulder engagement. Journal of orthopaedic surgery and research risk factors for shoulder redislocation after arthroscopic bankart repair hideaki shibata masafumi gotoh 0 yasuhiro mitsui 0 yoshihiro kai hidehiro nakamura tomonoshin kanazawa takahiro okawa 0 fujio higuchi 0 masahiro shirahama naoto shiba 0 department of orthopaedic surgery, kurume university medical center, 1551 kokubumachi, kurume. Imaging methods for quantifying glenoid and hillsachs bone loss in traumatic instability of the shoulder. We determined whether an arthroscopic bristowlatarjet procedure with concomitant bankart repair 1. To investigate the clinical outcomes after osteochondral allograft transplantation for large hillsachs lesions. Read the evaluation of hillsachs injuries and the use of humeral head allograft for repair of hillsachs and reverse hillsachs injuries, operative techniques in sports medicine on deepdyve, the largest online rental service for scholarly research with thousands of academic publications available at your fingertips. We would like to report the 2 year clinical outcomes of bioabsorbable suture anchors used in traumatic anterior dislocations of the shoulder. Article information, pdf download for arthroscopic bankart repair. Axial image showing reverse bony bankart arrow and the defect filled with. Background recent studies have shown effective clinical results after arthroscopic bankart repair abr but have shown several risk factors for redislocation after surgery. The hillsachs lesion is inspected for size and position relative to the articular surface and posterior rotator cuff insertion.
A hillsachs lesion represents an impression fracture of the posterolateral margin of the. A bony abnormality hill sachsbony bankart on standard series of xrays consisting of a minimum of an anteroposterior view, lateral in the scapular plane and an axillary view. If you continue browsing the site, you agree to the use of cookies on this website. The evaluation of hillsachs injuries and the use of. Treatment of chronic anterior shoulder dislocation by open. Clinical assessment consisted of active range of motion rom, american shoulder and elbow surgeons score ases, constantmurley score, rowe score, and patient. Evaluation of a treatment algorithm for acute traumatic. Surgeon agreement on the presence of pathologic anterior. It is an indication for surgery and often accompanied by a hillsachs lesion, damage to the posterior humeral head. The purpose of this study is to analyze the results after applying our treatment algorithm for acute glenoid rim fractures caused by first time traumatic anterior shoulder dislocations. Arthroscopic bristowlatarjet combined with bankart repair. If you do not see its contents the file may be temporarily unavailable at the journal website or you do not have a pdf plugin installed and enabled in your browser. We compared patients with recurrent posttraumatic anterior shoulder instability treated with arthroscopic. Complications may include a bankart lesion, hillsachs lesion, rotator cuff tear, or injury to the axillary nerve a shoulder dislocation often occurs as a result of a fall onto an outstretched arm or onto the shoulder.
We examined the glenoid track concept to determine if it provides a model that unifies. Operative treatment is common, including bony and softtissue reconstructions performed through open or arthroscopic approaches. Background traumatic anterior shoulder instability tasi accounts for 95% of glenohumeral dislocations and is associated with soft tissue and bony pathoanatomies. Osteochondral allograft transplantation for large hill. Management of humeral defects in anterior shoulder instability. The arthroscopic method offers a less invasive technique of bankart repair for traumatic anterior shoulder instability. Arthroscopic bankart repair alone cannot restore shoulder stability in patients with glenoid bone loss involving more than 20% of the glenoid surface. Combined allarthroscopic hillsachs remplissage, latarjet. Joint instability, shoulder dislocation, bankart lesions, hillsachs lesion. A bankart lesion is an injury of the anterior glenoid labrum of the shoulder due to anterior shoulder dislocation. Horst and his colleagues also found that a larger hill sachs lesion leads to greater.
An assortment of variables has been used in predicting anterior shoulder instability resulting from pathologic engagement of hillsachs lesions on the glenoid. Arthroscopic doublepulley remplissage using a 2portal. Whether youve loved the book or not, if you give your honest and detailed thoughts then people will find new books that are right for them. Imaging methods for quantifying glenoid and hillsachs. When this happens, a pocket at the front of the glenoid forms that allows the humeral head to dislocate into it. Studies dealing with acute osseous bankart lesions and corresponding treatment strategies are rare.
Imaging of the shoulder techniques and applications. Nonoperative treatments include slings, bracing and physiotherapy. Data from 79 shoulders in 74 patients were collected over 4 years 2004 2008. These defects may engage the glenoid rim, contributing to glenohumeral dislocation. Arthroscopic removal of metallic suture anchors placed. The aim of this study was to present our surgical outcomes in patients who underwent arthroscopic removal of poorly positioned andor proud metallic suture anchors applied during or after bankart repair. Treatment of a posterior hillsachs lesion in the right shoulder with a doublepulley remplissage. A total of 14 patients who underwent open or arthroscopic bankart repair with an initial presentation of traumatic shoulder instability between january 2010 and january 2017. Seven patients in whom closed reduction was possible were excluded from the study and the remaining eight patients were treated by open reduction and bankart lesion repair. Between november 2004 and september 2007, 15 patients with unilateral chronic anterior shoulder dislocation were referred to our clinic. Thirtyseven shoulders subjected to arthroscopic remplissage with a bankart repair group a and 35 shoulders subjected to a latarjet operation group b, for a large engaging hill sachs lesion without significant glenoid bone. Treatment of glenohumeral instability in rugby players. This study compared the clinical outcomes of arthroscopic remplissage with bankart repair and latarjet operation in patients with a large engaging hill sachs lesion. Perthes lesion a perthes lesion is a labroligamentous avulsion like a bankart, but with a medially stripped intact periosteum.
The incidence of these lesions in the setting of glenohumeral. Coracoid transposition to prevent recurrent shoulder dislocation according to bristowlatarjet is an efficient but controversial procedure. The physiologic groove in the humerus or cysts and erosions at the attachment site of the infraspinatus tendon can simulate a hill sachs, but usually this is not. A hill sachs lesion occurs when the lesion to the labrum presents simultaneously with a. Arthroscopic bankart repair combined with remplissage. Shoulder instability in the setting of bipolar glenoid. The purposes of this study were to answer the following questions. On mr a hill sachs defect is seen at or above the level of the coracoid. A multicentre randomized controlled trial comparing. Long term results of arthroscopic bankart repair for.