Microfracture in Linear, Isolated, Narrow, Engaging Hill-Sachs Lesion

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Presentation transcript:

Microfracture in Linear, Isolated, Narrow, Engaging Hill-Sachs Lesion Jae-Sung Yoo, M.D., Yong-Eun Shin, M.D., Kang Heo, M.D., Seong-Jun Kim, M.D., Joon-kyom Kim, M.D., Joong-Bae Seo, M.D. Arthroscopy Techniques Volume 7, Issue 12, Pages e1249-e1255 (December 2018) DOI: 10.1016/j.eats.2018.08.010 Copyright © 2018 Arthroscopy Association of North America Terms and Conditions

Fig 1 Patient in beach chair position, right shoulder, posterior viewing portal. Preoperative T2-weighted magnetic resonance image. (A) Anteroinferior labral tear (arrow). (B) Narrow Hill-Sachs lesion at posterior aspect of humeral head (arrowhead). Arthroscopy Techniques 2018 7, e1249-e1255DOI: (10.1016/j.eats.2018.08.010) Copyright © 2018 Arthroscopy Association of North America Terms and Conditions

Fig 2 Patient in beach chair position, right shoulder, posterior viewing portal. Width of whole glenoid (A) and relation between Hill-Sachs lesion (HS) and glenoid track (GT) (B). (BB, bone bridge.) Arthroscopy Techniques 2018 7, e1249-e1255DOI: (10.1016/j.eats.2018.08.010) Copyright © 2018 Arthroscopy Association of North America Terms and Conditions

Fig 3 Patient in beach chair position, right shoulder, posterior viewing portal. (A) Standard posterior, anterosuperior, and anteroinferior portals are established. (B) Bone bed preparation is performed with a burr. (C) The suture anchor is inserted at the glenoid cartilage margin. (D) A suture passer is used to shuttle 1 of the suture limbs through the labrum and capsule. (E) Knots are tied using the SMC knot technique, with care taken to keep the knots away from the glenoid face. (F) Overall, 4 anchors are applied. Arthroscopy Techniques 2018 7, e1249-e1255DOI: (10.1016/j.eats.2018.08.010) Copyright © 2018 Arthroscopy Association of North America Terms and Conditions

Fig 4 Arthroscopic images show a linear, isolated, narrow, engaging lesion (A) and a microfracture awl guided to penetrate the subchondral bone (B). (G, glenoid; HH, humeral head; HS, Hill-Sachs lesion.) Arthroscopy Techniques 2018 7, e1249-e1255DOI: (10.1016/j.eats.2018.08.010) Copyright © 2018 Arthroscopy Association of North America Terms and Conditions

Fig 5 Patient in beach chair position, right shoulder, posterior viewing portal. (A, B) Arthroscopic images show marrow fat and bleeding occurring from the microfracture holes. (G, glenoid; HH, humeral head; HS, Hill-Sachs lesion.) Arthroscopy Techniques 2018 7, e1249-e1255DOI: (10.1016/j.eats.2018.08.010) Copyright © 2018 Arthroscopy Association of North America Terms and Conditions

Fig 6 Patient in beach chair position, right shoulder, posterior viewing portal. (A, B) At 6 months after surgery, magnetic resonance imaging shows that the osteochondral defect is filled with regeneration of cartilage. The arrowheads indicate the black linear signal of cartilage regeneration. Arthroscopy Techniques 2018 7, e1249-e1255DOI: (10.1016/j.eats.2018.08.010) Copyright © 2018 Arthroscopy Association of North America Terms and Conditions