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Abstract Presented at the 26th Annual Meeting of the Arthroscopy Association of North America| Volume 23, ISSUE 6, SUPPLEMENT , e2, June 2007

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Arthroscopic ‘Filling’ of Hill Sachs Lesions (SS-03)

      Summary

      The presence of Bony lesions of the humerus occurring after anterior instability (Hill Sachs Lesions) may adversely affect prognosis for dislocation recurrence. The Senior Author has employed an arthroscopic means of delivering [email protected] (polylactide-co-glycolide) plugs to effect as least a partial ‘fill’ of the ‘engaging’ humeral head defect. Technical aspects of the procedure are delineated as is preliminary clincal data over the past 48 months.

      Purpose

      To report a new arthroscopic means of treating engaging humeral head defects found in anterior shoulder instability employing bone substitute.

      Methods

      Since 2004, the senior author has employed an arthroscpic means of attaining at least partial fill of ’engaging’ Hill sachs lesions of the humerus. The lesion is viewed from a proximal anterior portal and approached with an accessory posterior portal approximately 2cm medial and often distal to the standard posterior portal, although rarely lesion access is attained via the standard posterior portal. The lesion is debrided with a shaver and approached with an arthroscopic trephine (OATS System - Arthrex, Naples Florida). A bony bed of approximately 13mm is attained and subsequently filled with donor plugs of [email protected] (OBI - Osteobiologics, San Antonio Texas) roughly 2mm longer than the prepared bony bed. The plugs are countoured to the bed with an oversized tamp and fit to match the countour of the articular surface.

      Results

      12 patients underwent arthroscopic grafting of the engaging humeral head lesions using bone substitute. No significant intraoperative complications were experienced, nor were any deficits of the axillary nerve or infections noted. Clinical results are pending.

      Conclusions

      Engaging Hill Sachs lesions of the humeral head can be at least partially filled arthroscopically with bone substitute. No untoward effects or added patient morbidity appears to be the result of this technique. Clinical results are pending.