Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Feb 28;8(4):686-691.
doi: 10.1016/j.jseint.2024.02.004. eCollection 2024 Jul.

Arthroscopic humeral head defect filling with osteochondral autografts transplantation for near-track Hill-Sachs lesions

Giuseppe Milano  1   2 , Alessandro Colosio  1 , Monica Agosti  3 , Andrea Bergomi  1 , Maristella F Saccomanno  1   2
Affiliations

Arthroscopic humeral head defect filling with osteochondral autografts transplantation for near-track Hill-Sachs lesions

Giuseppe Milano et al. JSES Int. .
No abstract available

Keywords: Autologous ostechondral transplantation; Bipolar bone loss; Gleno-humeral instability; Hill sachs; Near-track; On-track.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Preoperative assessment of HSL size. Through 3D-CT reconstruction of the HH, the number and size of grafts needed to fill the defect can be planned. Only the articular part of the HS is considered. HSL, Hill-Sachs lesion; HH, humeral head; HS, Hill-Sachs; CT, computed tomography; 3D, three-dimensional.
Figure 2
Figure 2
Lateral decubitus, left knee (ipsilateral to the affected shoulder): Through a lateral mini-arthrotomy, the proximal lateral aspect of the femoral trochlea (donor site) is exposed. The donor harvester is positioned perpendicular to the donor surface and impacted to a depth of approximately 15 mm.
Figure 3
Figure 3
Arthroscopic view through anterior-superior portal of left shoulder with patient in lateral decubitus. (A) Through the cannula placed in the posterior portal, the recipient harvester is positioned perpendicular to the osteochondral defect and impacted to a depth of 10-13 mm, then the harvester is removed, creating the bone socket; (B) A graduated alignment rod is used to measure the final recipient socket depth and check the correct insertion angle.
Figure 4
Figure 4
Arthroscopic view through anterior-superior portal of left shoulder with patient in lateral decubitus. The graft, taken from the knee still inside the donor harvester through the posterior portal is inserted and press-fitted perpendicularly into the recipient socket.
Figure 5
Figure 5
Arthroscopic view through anterior-superior portal of left shoulder with patient in lateral decubitus. Thanks to a specific plastic tamp in the posterior portal, final graft placement is performed at the level of the cartilage edge.
Figure 6
Figure 6
Arthroscopic view through posterior portal of left shoulder with patient in lateral decubitus. Final result at the end of the procedures, with the HSL filled by multiple grafts. HSL, Hill-Sachs lesion.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Alkaduhimi H., van den Bekerom M.P.J., van Deurzen D.F.P. Step-by-step technique for segmental reconstruction of reverse Hill-Sachs lesions using homologous osteochondral allograft. Tech Hand Up Extrem Surg. 2017;21:60–66. doi: 10.1097/BTH.0000000000000151. - DOI - PubMed
    1. Brzóska R., Laprus H., Michniowski P., Solecki W., Klon W., Błasiak A. Novel and effective arthroscopic extracapsular stabilization technique for anterior shoulder instability-BLS. Knee Surg Sports Traumatol Arthrosc. 2019;27:3897–3904. doi: 10.1007/s00167-019-05496-1. - DOI - PubMed
    1. Burkhart S.S., Danaceau S.M. Articular arc length mismatch as a cause of failed bankart repair. Arthroscopy. 2000;16:740–744. - PubMed
    1. Chalmers P.N., Christensen G., O’Neill D., Tashjian R.Z. Does bone loss imaging modality, measurement methodology, and interobserver reliability alter treatment in glenohumeral instability? Arthroscopy. 2020;36:12–19. doi: 10.1016/j.arthro.2019.06.025. - DOI - PubMed
    1. Chapovsky F., Kelly J.D. Osteochondral allograft transplantation for treatment of glenohumeral instability. Arthroscopy. 2005;21:1007. doi: 10.1016/j.arthro.2005.04.005. - DOI - PubMed

LinkOut - more resources