Percutaneous balloon humeroplasty for Hill-Sachs lesions: a novel technique

Stachowicz, Rafal Z.; Romanowski, James R.; Wissman, Robert D.; Kenter, Keith

doi:10.1016/j.jse.2012.12.035

Cited by 23 publications

(9 citation statements)

References 18 publications

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“…Stachowicz et al [63] conducted a similar study with 18 cadaveric humeri. They used a kyphoplasty balloon to reduce the Hill-Sachs lesion and then injected bone cement into the void.…”

Section: Hill-sachs Reductionmentioning

confidence: 99%

Understanding the Hill-Sachs Lesion in Its Role in Patients with Recurrent Anterior Shoulder Instability

Fox

Sanchez

Zajac

et al. 2017

Curr Rev Musculoskelet Med

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The most recent literature covering the Hill-Sachs lesion has focused on the relatively new and unexplored topic of the importance of concomitant injuries while treating a humeral head defect. The glenoid track concept has been clinically validated as a method to predict engagement. 3D-CT has become the "gold standard" for Hill-Sachs imaging; however, it has been noted that 3D-MRI produces results that are not significantly different from CT. Also, it has been found that when the arm is in a position of abduction during the primary injury, there is a higher risk of engagement and subsequent dislocation. Recent studies have demonstrated successful results stemming from purely arthroscopic procedures in treating Hill-Sachs lesions. Anterior shoulder instability, specifically the Hill-Sachs lesion, is an area of orthopedic study that is highly active and constantly producing new studies in an attempt of gaining the best outcomes for patients. The past few years have yielded many excellent discoveries, but there is still much more work to be done in order to fully understand the role of the Hill-Sachs lesion in anterior shoulder instability.

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“…Stachowicz et al [63] conducted a similar study with 18 cadaveric humeri. They used a kyphoplasty balloon to reduce the Hill-Sachs lesion and then injected bone cement into the void.…”

Section: Hill-sachs Reductionmentioning

confidence: 99%

Understanding the Hill-Sachs Lesion in Its Role in Patients with Recurrent Anterior Shoulder Instability

Fox

Sanchez

Zajac

et al. 2017

Curr Rev Musculoskelet Med

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show abstract

“…Alternatively, percutaneous balloon humeroplasty is currently undergoing biomechanical cadaveric and early clinical attempts. 8,9 Reconstruction with fresh osteochondral allograft is a promising operative technique to address reverse HillSachs lesions in the case of failed McLaughlin and remplissage procedures 10 or during primary surgical repair of large, engaging reverse Hill-Sachs lesions. A fresh humeral osteochondral allograft has been used for anatomic reconstruction of a reverse Hill-Sachs lesion and has the additional benefit of addressing the associated chondral deficiency.…”

mentioning

confidence: 99%

Anatomic Humeral Head Reconstruction With Fresh Osteochondral Talus Allograft for Recurrent Glenohumeral Instability With Reverse Hill-Sachs Lesion

Provencher

Sánchez

Schantz

et al. 2017

Arthroscopy Techniques

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The treatment of recurrent glenohumeral instability, especially with a concomitant bony lesion, remains challenging. This is especially true in the case of posterior instability given its less common incidence. Moreover, the presence of an engaging reverse Hill-Sachs lesion in combination with posterior instability will result in the need for a more aggressive treatment option. In comparison with a Hill-Sachs lesion, a reverse Hill-Sachs lesion features greater chondral deficiency that must be addressed during treatment. We propose the talus allograft as a potential allograft for treatment of an engaging reverse Hill-Sachs lesion. The superior articular surface of the talus may be used to reconstruct the articular surface of the humeral head. In this technical note, we describe our preferred primary technique for treatment of an engaging reverse Hill-Sachs lesion with recurrent glenohumeral instability through use of a fresh osteochondral talus allograft, as well as discuss the advantages and disadvantages of this allograft option.

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“…They used 6 cadaveric specimens for their study and showed that a balloon kyphoplasty system could reduce the size of a Hill-Sachs lesion by 80%, but they noted that further studies needed to be performed to evaluate the technique under arthroscopic conditions. Stachowicz et al 13 injected bone cement after using the kyphoplasty balloon. They used 18 cadaveric humeri and were able to show a 99.3% reduction to the original humeral head volume.…”

Section: Discussionmentioning

confidence: 99%

“…More recently, Sandmann et al 12 described the use of a kyphoplasty balloon with subsequent filling of the defect with bone substitute (similar to the fixation of a vertebral compression fracture), which they performed on cadaveric specimens. Stachowicz et al 13 described the same technique used on cadavers. To our knowledge, there is only one mention of this technique being used in live patients: Jacquot et al 14 used fluoroscopic guidance to perform a humeroplasty on 4 different shoulders with reverse Hill-Sachs lesions.…”

mentioning

confidence: 99%

Arthroscopic Reduction and Balloon Humeroplasty in the Treatment of Acute Hill-Sachs Lesions

Ratner

Backes

Tokish

2016

Arthroscopy Techniques

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Shoulder instability is often associated with an impaction fracture of the humeral head, commonly referred to as a "Hill-Sachs lesion." This lesion is present in both anterior and posterior instability. Forty percent to 90% of anterior shoulder dislocations have associated Hill-Sachs lesions, whereas 29% to 86% of posterior shoulder dislocations have reverse Hill-Sachs lesions. Both of these lesions can contribute to recurrent instability of the shoulder and require surgery to be treated. Currently, the most common procedures to address Hill-Sachs lesions are the remplissage procedure (transfer of the infraspinatus into the posterior humeral head defect), capsular shift, disimpaction technique, humeral head resurfacing, bone block transfer, or shoulder arthroplasty. Reverse Hill-Sachs lesions are managed with similar procedures, such as the remplissage-equivalent technique described by McLaughlin, which involves transfer of the subscapularis tendon to fill the humeral head defect. The procedure has the advantage of "exteriorizing" the humeral head defect, but in the case of large lesions, it can result in significant loss of the articulating articular surface. The purpose of this article is to describe an arthroscopically assisted disimpaction technique with supplemental grafting using a balloon osteoplasty technique for a reverse Hill-Sachs lesion with bone cement to support and maintain the reduction.

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Percutaneous balloon humeroplasty for Hill-Sachs lesions: a novel technique

Cited by 23 publications

References 18 publications

Understanding the Hill-Sachs Lesion in Its Role in Patients with Recurrent Anterior Shoulder Instability

Understanding the Hill-Sachs Lesion in Its Role in Patients with Recurrent Anterior Shoulder Instability

Anatomic Humeral Head Reconstruction With Fresh Osteochondral Talus Allograft for Recurrent Glenohumeral Instability With Reverse Hill-Sachs Lesion

Arthroscopic Reduction and Balloon Humeroplasty in the Treatment of Acute Hill-Sachs Lesions

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