Hill–Sachs lesions are best treated with a surface replacement—Affirms

A Hill–Sachs lesion is a compression fracture of the humeral head in occurrence with anterior glenohumeral instability. Quantification of the “significance” of a Hill–Sachs lesion with regard to location, size, and depth in relation to the glenoid has helped guide indications for surgical management. The majority of significant Hill–Sachs lesions can be effectively managed without prosthetic replacement. The peer-reviewed literature is sparse with the outcomes of this treatment, and significant consideration must be given to both the age of the patient and the need for such management when other effective non-prosthetic options exist. In a patient with greater than half of the humeral head involved after instability, metallic surface replacement arthroplasty may be an option for restoring range of motion and stability.