Management of the deep hill-sachs lesion

Abstract

The Hill-Sachs lesion is a very common and well-known phenomenon associated with shoulder instability. Since the first description in 1940 on an X-ray performed after anterior shoulder dislocation, its diagnosis, importance, and treatment have changed substantially. Currently, after introducing to daily practice a few scores that underline the importance of this lesion, such as the popular ISIS score, its meaning is still emphasized. Further, in predicting the risk of instability recurrence after dislocation in the also popular glenoid track concept, the surgeon must combine the size and placement of the Hill-Sachs lesion with glenoid bone loss (GBL), which occurs after shoulder dislocation. The necessity to precisely assess the Hill-Sachs lesion forces us to look for new diagnosing methods and classification systems. In this chapter, the current state of knowledge, consisting of diagnostic methods, classification systems, and treatment options depending on many factors, is presented as an accessible summary.