Specialized Toolkit Series: Shoulder Instability-Alphabet Soup

Alphabet Soup – Fixing the HAGL & rHAGL

Video Transcription

Video Summary

Steve Perata from the Medical College of Georgia discusses diagnosing and repairing rare and challenging shoulder lesions called Hagl and reverse Hagl lesions. These injuries, often missed on routine MRI unless imaging is done in the correct plane, cause significant morbidity if untreated. He emphasizes correlating high-energy injury history with imaging findings. For Hagl lesions, he prefers a mini open repair via a small subscapularis window, using a cuff anchor and mattress sutures. Reverse Hagl lesions are more amenable to arthroscopic repair with multiple posterior portals, careful anchor placement, and mattress sutures to restore capsular tension. Practice and anatomical knowledge are crucial for successful outcomes.

Asset Caption

Stephen A. Parada, M.D.

Keywords

Hagl lesions

reverse Hagl lesions

shoulder injury diagnosis

mini open repair

arthroscopic repair