Combined arthroscopic-open procedure for the recurrent shoulder dislocation in a 74-year-old man with an irreparable massive rotator cuff tear and a large Hill-Sachs lesion |
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Authors: | Choon Key Lee Hyung Lae Cho Man Jun Park Kuen Tak Suh |
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Institution: | (1) Department of Orthopaedic Surgery, Gangbuk Himchan Hospital, 650-46 Chang-Dong, Dobong-Gu, Seoul, 132-040, Korea;(2) Department of Orthopaedic Surgery, Good Samsun Hospital, 193-5 Churye-Dong, Sasang-Gu, Pusan, 617-718, Korea;(3) Department of Orthopaedic Surgery, Pusan National University Yangsan Hospital, Beomeo-ri, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, 626-770, Korea |
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Abstract: | Large, engaging Hill-Sachs lesions can be one of causes for recurrent glenohumeral instability after initial anterior shoulder
dislocation or Bankart repair for the torn anteroinferior labrum. However, there have been relatively few articles describing
specific treatments for the humeral head defects. This article described a case of an alternative treatment for large Hill-Sachs
lesion using the corticocancellous iliac autograft. The authors present a case of recurrent anterior shoulder dislocation,
with a large humeral head defects, and an irreparable massive rotator cuff tear in a 74-year-old man. The size of this Hill-Sachs
lesion was 2.7 × 2 cm with a depth of 1.2 cm. After arthroscopic anterior capsulolabral repair, a 3 × 2 cm semicircular graft
was harvested from the inner table of anterior iliac crest, trimmed, and transplanted to the humeral defect by cancellous
screw fixation. At his 2-year follow-up, the patient remained free of dislocation and apprehension. We recommend this technique
as an alternative method for symptomatic patients with engaging Hill-Sachs lesion. |
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