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Arthroscopic Hill-Sachs Filling Technique Using an Absorbable Interference Screw.

Angelo C C Di Giunta1, Alfonso Massimiliano Cassarino1, Sergio Castorina1,2

  • 1Fondazione Mediterranea "G.B. Morgagni," Catania, Italy.

Arthroscopy Techniques
|January 12, 2023
PubMed
Summary

This study introduces an arthroscopic method for shoulder instability using bioabsorbable screws to repair Hill-Sachs lesions. This technique restores bone anatomy, improving outcomes for patients with traumatic shoulder injuries.

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Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Biomaterials Science

Background:

  • Traumatic shoulder instability frequently involves Hill-Sachs lesions, particularly off-track defects.
  • These bony defects occur in 40-100% of anterior shoulder instability cases.
  • Inadequate management of Hill-Sachs lesions can result in treatment failure.

Purpose of the Study:

  • To present a novel arthroscopic technique for managing Hill-Sachs lesions in patients with traumatic shoulder instability.
  • To describe the use of advanced biocomposite interference screws for bone defect repair.
  • To outline the sequential repair of the Hill-Sachs lesion followed by the Bankart lesion.

Main Methods:

  • Arthroscopic surgical intervention for traumatic shoulder instability.
  • Utilizing absorbable interference screws composed of a biocomposite material to fill the Hill-Sachs lesion.
  • Performing a Bankart lesion repair subsequent to the Hill-Sachs lesion management.

Main Results:

  • The described arthroscopic technique effectively addresses Hill-Sachs lesions, including off-track variants.
  • The biocomposite screws are gradually resorbed and replaced by bone tissue over several months.
  • Restoration of normal humeral head anatomy is achieved, potentially reducing recurrence rates.

Conclusions:

  • Arthroscopic management of Hill-Sachs lesions with bioabsorbable interference screws offers a viable treatment option.
  • This technique facilitates anatomical restoration and may improve long-term outcomes for shoulder instability.
  • The use of advanced biomaterials in arthroscopic shoulder surgery presents a promising approach.