Osteoarticular allograft reconstruction for hill-sachs lesion in an adolescent

Orthopedics
Senthil T Nathan, Shital N Parikh

Abstract

Glenoid and humeral head bone loss is the most common cause of failure after surgical shoulder instability stabilization. Large Hill-Sachs lesions involving >30% of the articular surface of the humeral head typically occur after neglected or locked shoulder dislocations. Such large lesions may require osteochondral allograft reconstruction or prosthetic replacement to regain shoulder stability and function.Previous reports of osteochondral allograft reconstruction have focused on adults. This article describes a case of a 16-year-old autistic boy who sustained an anterior dislocation of the right shoulder following a seizure episode. The dislocation was diagnosed 12 days later as a progressive deformity, and his parents noticed his inability to use his upper extremity. The patient had a large (30%) humeral head Hill-Sachs lesion and persistent anterior shoulder instability after initial closed reduction. He underwent an open osteochondral allograft reconstruction for the restoration of the humeral head articular surface. The sizing of the defect, matching harvest of the allograft, and perfect fit of the allograft to the defect are critical steps to ensure congruent restoration of the humeral head. The allograft was stabilized i...Continue Reading

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Citations

May 17, 2015·Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association·Bryan M SaltzmanAdam B Yanke
Jan 2, 2018·The Open Orthopaedics Journal·Jonathan Brian YatesMohammad Waseem
Jun 11, 2014·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Evan ArgintarThay Q Lee

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