Specialized Toolkit Series: Shoulder Instability-Humeral Head Bone Loss: You Should Be Paying More Attention!

Humeral Head Bone Loss: You Should Be Paying More Attention!

Video Transcription

Video Summary

This talk addressed shoulder instability, emphasizing the often overlooked role of humeral head bone loss (Hill-Sachs lesions) alongside glenoid bone loss in recurrent dislocations. Biomechanical studies show lesion size and location critically affect stability. Proper imaging, including MRI and CT, helps assess "on-track" vs. "off-track" lesions, influencing treatment choices. The Remplissage technique, a capsulotenodesis procedure, reduces recurrence rates even for lesions previously considered low risk. Surgical positioning (beach chair vs. lateral decubitus) showed no significant difference in outcomes; instead, factors like patient age, number of prior dislocations, and bone loss dictate prognosis. Early intervention post-first dislocation yields better stabilization success.

Asset Caption

Drew A. Lansdown, M.D.

Keywords

shoulder instability

humeral head bone loss

Hill-Sachs lesions

Remplissage technique

early intervention