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Percutaneous balloon humeroplasty for Hill-Sachs lesions: a novel technique.

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Percutaneous balloon humeroplasty for Hill-Sachs lesions: a novel technique.

J Shoulder Elbow Surg. 2013 Sep;22(9):e7-13

Authors: Stachowicz RZ, Romanowski JR, Wissman R, Kenter K

Abstract
INTRODUCTION: Hills-Sachs lesions are commonly associated with anterior shoulder dislocations and can be a source of recurrent instability. Studies have shown that, even after soft tissue repair of a Bankart lesion, there is still a risk for redislocation in a patient with significant bony defects. The purpose of this study is to ascertain whether balloon humeroplasty is an effective technique of reducing acute Hill-Sachs defect in a cadaveric model.
METHODS: Eighteen cadaveric humerii dissected free of soft tissue were used for this study. Hill-Sachs lesions were created in a reproducible manner in the anatomical posterolateral aspect of the head with a mallet edge. An inflatable balloon tamp (balloon, IBT) was used to reduce the lesion via a small transcortical window. Cement was used to fill the void created by the balloon. We utilized computed tomography (CT) to collect volume data of each humeral head pre- and post-procedure. From this data, we calculated the volume of the Hill-Sachs defect and the percent corrected. A paired t test was performed to analyze the data statistically.
RESULTS: The average prereduction Hill-Sachs defect volume was 1515.5 mm(3). The average post-reduction lesion residual volume was 31 mm(3) with 99.3% reduction to the original humeral head volume. The Hill-Sachs lesion reduction was statistically significant with P value of .0004.
CONCLUSION: Balloon humeroplasty proved to be an effective technique for reducing Hill-Sachs lesions in a cadaveric model. This technique may be used as an adjunct to arthroscopic versus open Bankart procedure for engaging acute Hill-Sachs lesions.

PMID: 23473608 [PubMed – indexed for MEDLINE]

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