How to measure a Hill-Sachs lesion: A systematic review

Abstract

Quantifying bone loss is important to decide the best treatment for patients with recurrent anterior glenohumeral instability. Currently, there is no standard method available to make a precise evaluation of the Hill-Sachs lesion and predict its engagement before the surgical procedure. This literature review was performed in order to identify existing published imaging methods quantifying humeral head bone loss in Hill-Sachs lesions. Searches were undertaken in Scopus and PubMed databases from January 2008 until February 2018. The search terms were "Hill-Sachs" and "measurement" for the initial search and "Hill-Sachs bone loss" for the second, to be present in the keywords, abstracts and title. All articles that presented a method for quantifying measurement of Hill-Sachs lesions were analysed. Several methods are currently available to evaluate Hill-Sachs lesions. The length, width and depth measurements on CT scans show strong inter and intra-observer correlation coefficients. Three-dimensional CT is helpful for evaluation of bony injuries; however, there were no significant differences between 3D CT and 3D MRI measurements. The on-track off-track method using MRI allows a simultaneous evaluation of the Hill-Sachs and glenoid bone loss and also predicts the engaging lesions with good accuracy.