Original article| Volume 21, ISSUE 12, P1473-1478, December 2005

Percutaneous Correction (Humeroplasty) of Humeral Head Defects (Hill-Sachs) Associated With Anterior Shoulder Instability: A Cadaveric Study

      Purpose: The goal of our study was to determine whether a bone tamp could be used to correct a Hill-Sachs lesion by a unique technique that we developed termed “humeroplasty.” Type of Study: In vitro cadaveric study. Methods: We created reproducible Hill-Sachs lesions in 14 cadaveric humerii, which we then reduced with a curved bone tamp using our proposed technique. Paired t tests, with the significance set at P < .05, were then used to compare the prereduction and postreduction depths, widths, lengths, and volumes of the lesions. Results: The average prereduction defect measurements were 8.9 mm deep, 16.3 mm wide, 24.1 mm long, and 1,755 mm3 in volume. The average postreduction defect measurements were 1.6 mm deep, 6.2 mm wide, 10.4 mm long, and 50.3 mm3 in volume. A statistically significant improvement (P < .001) was seen in all parameters. Conclusions: Our technique was able to consistently and significantly restore all measured parameters of the Hill-Sachs lesions using a curved bone tamp. This reduction to a “small” defect may reduce the higher rate of recurrence normally found with the surgical treatment of shoulder instability when “large” Hill-Sachs lesions are present. Clinical Relevance: Humeroplasty potentially might reduce the higher rate of recurrence observed when the surgical treatment of shoulder instability involves the presence of large Hill-Sachs lesions.

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        • Hill H.A.
        • Sachs M.D.
        The grooved defect of the humeral head. A frequently unrecognized complication of dislocations of the shoulder joint.
        Radiology. 1940; 35: 690-700
        • Burkhart S.S.
        • DeBeer J.F.
        Traumatic glenohumeral bone effects and their relationship to failure of arthroscopic Bankart repairs.
        Arthroscopy. 2000; 16: 677-694
        • Burkhart S.S.
        • Danaceau S.M.
        Articular arc length mismatch as a cause of failed Bankart repair.
        Arthroscopy. 2000; 16: 740-744
        • Ito H.
        • Takayama A.
        • Shirai Y.
        Radiographic evaluation of the Hill-Sachs lesion in patients with recurrent anterior shoulder instability.
        J Shoulder Elbow Surg. 2000; 9: 495-497
        • Kirkley A.
        • Griffin S.
        • Richards C.
        • Miniaci A.
        • Mohtadi N.
        Prospective randomized clinical trial comparing the effectiveness of immediate arthroscopic stabilization versus immobilization and rehabilitation in first traumatic anterior dislocations of the shoulder.
        Arthroscopy. 1999; 15: 507-514
        • Richards R.D.
        • Sartoris D.J.
        • Pathria M.N.
        • Resnick D.
        Hill-Sachs lesion and normal humeral groove.
        Radiology. 1994; 190: 665-668
        • Connolly J.F.
        Humeral head defects associated with shoulder dislocations—Their diagnostic and surgical significance.
        Instr Course Lect. 1972; 21: 42-54
        • Rowe C.R.
        • Patel D.
        • Southmayd W.W.
        The Bankart procedure. A long-term end-result study.
        J Bone Joint Surg Am. 1978; 60: 1-16
        • Weber B.G.
        • Simpson L.A.
        • Hardegger F.
        Rotational humeral osteotomy for recurrent anterior dislocation of the shoulder associated with a large Hill-Sachs lesion.
        J Bone Joint Surg Am. 1984; 66: 1443-1450
        • Neer C.S.H.
        in: Shoulder reconstruction. WB Saunders, Philadelphia1990: 273-341
        • DeBerardino T.M.
        • Arciero R.A.
        • Taylor D.C.
        • Uhorchak J.M.
        Prospective evaluation of arthroscopic stabilization of acute, initial anterior shoulder dislocations in young athletes.
        Am J Sports Med. 2001; 29: 586-592
        • Flatow E.L.
        • Warner J.J.P.
        Instability of the shoulder: Complex problems and failed repairs: Part I. Relevant biomechanics, multidirectional instability, and severe loss of glenoid and humeral bone.
        J Bone and Joint Surg Am. 1998; 80: 122-140
        • Hattrup S.J.
        • Cofield R.H.
        • Weaver A.L.
        Anterior shoulder reconstruction.
        J Shoulder and Elbow Surg. 2001; 10: 508-513
        • Hawkins R.J.
        • Angelo R.L.
        Glenohumeral osteoarthritis.
        J Bone and Joint Surg Am. 1990; 72: 1193-1197
        • Bankart A.S.B.
        Discussion on recurrent dislocation of the shoulder.
        J Bone Joint Surg Br. 1948; 30: 47
        • Danzig L.A.
        • Greenway G.
        • Resnick D.
        The Hill-Sachs lesion.
        Am J Sports Med. 1980; 8: 328-332
        • Calandra J.J.
        • Baker C.L.
        • Uribe J.
        The incidence of Hill-Sachs lesions in initial anterior shoulder dislocations.
        Arthroscopy. 1989; 5: 254-257
        • Rowe C.R.
        • Zarins B.
        • Ciullo J.V.
        Recurrent anterior dislocation of the shoulder after surgical repair. Apparent causes of failure and treatment.
        J Bone Joint Surg Am. 1984; 66: 159-168
        • Kralinger F.S.
        • Golser K.
        • Wischatta R.
        • Wambacher M.
        • Sperner G.
        Predicting recurrence after primary anterior shoulder dislocation.
        Am J Sports Med. 2002; 30: 116-120