Treatment of engaging iesions in anterior shoulder instability by infraspinatus fixation

Abstract

Objective To treat anterior shoulder instability associated with an engaging Hill-Sachs lesion by insetting the infraspinatus into the Hill-Sachs lesion. Methods From March 2007 to July 2010,15 cases of anterior shoulder instability with large Hill-Sachs lesion were surgically treated.There were 10 males and 5 females.Patient ages ranged from 18 to 45 years,with an average of 35.2 years.The Bankart lesion was repaired by placing and passing the glenoid anchors to fasten the anterior capsule.Another 2 anchors were used to inset the infraspinatus tendon into the Hill-Sachs defect. Results All the patients were follow-up for 12 to 22 months (average 17 months).The results were excellent in 12 cases and good in 3 cases according to Rowe scale.There was no recurrent dislocation. Conclusion Using two additional anchors to firmly compress the infraspinatus tendon against the bone bed of the Hill-Sachs lesion may be an ideal surgical approach for the treatment of anterior shoulder instability with large Hill-Sachs lesion. Key words: Shoulder joint; Arthroscopes; Infraspinatus tendon; Engaging lesions