Arthroscopic humeral head defect filling with osteochondral autografts transplantation for near-track Hill-Sachs lesions

BackgroundA higher likelihood of failure following Bankart repair has been showed in patients with near track lesions. Although several techniques have been described to address subcritical glenoid bone loss, the management of the Hill-Sachs (HS) lesions remains a challenge. The purpose of this article was to present an arthroscopic technique to fill the articular part of the HS lesion with osteochondral autografts harvested from ipsilateral knee.Material and methodsPatients affected by primary or recurrent anterior gleno-humeral instability with evidence of a near-track lesion at computed tomography (CT) scan and arthroscopic confirmation, are suitable candidates to this technique. Focusing on the humeral side, patients affected by HSLs involving the articular part of the HH with the Hill-Sachs occupancy >75% (peripheral track lesions) are good candidates for this procedure. It consists of articular humeral head (HH) filling with osteochondral autografts harvested from the lateral border of the lateral femoral condyle of the knee.ConclusionThe arthroscopic HH filling with osteochondral autografts transplantation for near-track HS lesions is a viable anatomic option in primary and recurrent glenohumeral instability.