Hill-Sachs lesions revisited

Abstract

Background: The anterior shoulder instability is often associated with a bony defect in the humeral head which is known as a Hill-Sachs lesion that is caused by compression fracture. It causes significant disability, particularly in younger patients, due to recurrent shoulder instability. The severity of the instability, the extent of the defect, and the concomitant pathology of the capsule, labrum, and glenoid influence the treatment. Purpose and Methods: The purpose of this review paper is to provide up-to-date details of the clinical evaluation, current diagnostic tools, and treatment modalities. We shall also discuss the lacunae in the treatment guidelines, and suggest the treatment algorithm. We reviewed several articles in the literature (PubMed, Scopus, and Google Scholar) on this topic, especially the mechanism of injury, diagnosis, and treatment methods to produce a review article. Conclusion: There are multiple methods for diagnosing the Hill-Sachs lesion, but there is no commonly accepted technique for quantifying it. A thorough evaluation is mandatory to verify the associated pathology that can modify the treatment protocols. An algorithm has been proposed for the management of Hill-Sachs defects.