Drew Ratner, M.D., Jeffrey Backes, M.D., John M. Tokish, M.D.

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Presentation transcript:

Arthroscopic Reduction and Balloon Humeroplasty in the Treatment of Acute Hill-Sachs Lesions Drew Ratner, M.D., Jeffrey Backes, M.D., John M. Tokish, M.D. Arthroscopy Techniques Volume 5, Issue 6, Pages e1327-e1332 (December 2016) DOI: 10.1016/j.eats.2016.08.007 Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 1 (A) Axial computed tomography image showing a reverse Hill-Sachs lesion (arrow). (B) Anterior aspect of a 3-dimensional computed tomography rendition of the reverse Hill-Sachs lesion (arrow). (F, foot; L, left; R, right.) Arthroscopy Techniques 2016 5, e1327-e1332DOI: (10.1016/j.eats.2016.08.007) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 2 (A) View from the anterior portal showing a posterior labral tear and reverse Hill-Sachs lesion (RHS) of the humeral head. (B) Same view after the posterior labrum is repaired with 3 suture anchors. (G, glenoid; HH, humeral head.) Arthroscopy Techniques 2016 5, e1327-e1332DOI: (10.1016/j.eats.2016.08.007) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 3 In the lateral position, viewing from posteriorly, an anterior cruciate ligament guide is placed against the humeral head (HH) defect to accurately place the guide pin. (G, glenoid.) Arthroscopy Techniques 2016 5, e1327-e1332DOI: (10.1016/j.eats.2016.08.007) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 4 (A) In the lateral position, viewing from the anterior portal, the drill bit is shown exiting the humeral head (HH) defect, serving as a guide pin for the cannula. The cannula will be used to introduce the balloon, which is deployed to reduce the Hill-Sachs defect. (G, glenoid.) (B) Anteroposterior fluoroscopic picture of the drill exiting the humeral head defect. Arthroscopy Techniques 2016 5, e1327-e1332DOI: (10.1016/j.eats.2016.08.007) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 5 (A) Insertion of the cannula (C) and inflation of the balloon (B) to 150 mm Hg, facilitating reduction of the Hill-Sachs lesion. (B) In the lateral position, viewing from the posterior portal, the humeral head (HH) defect is shown, after it has been reduced by the balloon (visualized in A). (G, glenoid.) Arthroscopy Techniques 2016 5, e1327-e1332DOI: (10.1016/j.eats.2016.08.007) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 6 Fluoroscopic image showing insertion of the cannula with injection of calcium phosphate (visualized as density in the humeral head [arrow]) to fill the void left after the Hill-Sachs lesion has been reduced. Arthroscopy Techniques 2016 5, e1327-e1332DOI: (10.1016/j.eats.2016.08.007) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions