Shoulder

Hill Sachs Lesion

What is a Hill Sachs lesion?

A Hill Sachs lesion is damage to humeral head, or ball that occurs after shoulder dislocation. The Hill Sachs lesion occurs when the back of the ball engages with the front of the socket during an anterior shoulder dislocation.

The shoulder joint is the most mobile joint in the body, and the large bony "ball" has to balance on a relatively smaller socket, in the same way a golf ball is balanced on a tee. A Hill Sachs lesion can cause the ball to slip forward and engage or “lock” on the glenoid rim.

What causes a Hill Sachs lesion?

A Hill Sachs lesion is created when the shoulder dislocates anteriorly. When the shoulder dislocates out of place, the large bony ball can become damaged and dented from the rim of the socket. Similar damage that occurs when the shoulder dislocates posteriorly is called a "reverse Hill Sachs."

How is a Hill Sachs leison diagnosed?

A Hill Sachs lesion is typically diagnosed with X-ray, which will show the bony damage after a dislocation. A Hill Sachs may be seen on MRI, or CT scan.

How is a Hill Sachs lesion treated?

A Hill Sachs lesion is managed as a part of managing shoulder dislocation. Shoulder dislocations may be treated nonoperatively (with physical therapy and medication) or with surgery. This depends on a number of factors that your surgeon will take into account, including how significant the damage is; your age and activity level; whether this was a first time or subsequent dislocation; and your occupation or work requirements.

What happens if I need surgery?

Hill Sachs lesions are typically treated with shoulder arthroscopy and arthroscopic repair of the damaged tissues. Occasionally, this may require a remplissage, which is an arthroscopic treatment in which the cuff tissue is secured into the bony defect on the ball.