ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2021
Off-track Hill-Sachs lesions predispose to recurrence after nonoperative management of first-time anterior shoulder dislocations.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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13 citing papers in PubMed, 23 citations in OpenAlex.
- Clinical and radiological factors associated with recurrent shoulder dislocation after conservative treatment of traumatic primary anterior shoulder dislocation.Journal of orthopaedic surgery and research · 2026Article
- Four-dimensional computed tomography can visualise the in vivo glenoid track and quantify dynamic glenohumeral contact mechanics during active motion in subjects with shoulder instability: A preliminary study.Journal of experimental orthopaedics · 2026Article
- Unperceived First-Time Anterior Shoulder Subluxation: The Role of MRI in Detection and Characterization of Pathoanatomy.Orthopaedic journal of sports medicine · 2026Article
- EVIDENCE-BASED REVIEW & RECOMMENDATIONS FROM THE BRAZILIAN SOCIETY OF SHOULDER AND ELBOW SURGERY: BANKART REPAIR WITH REMPLISSAGE FOR RECURRENT GLENOHUMERAL INSTABILITY WITH BONE LOSS.Acta ortopedica brasileira · 2026Review
- Advances in Shoulder Pain Imaging: A Narrative Review of Current Practice and Emerging Trends.Current medical imaging · 2025Article
- Role of clinical and radiological parameters for recurrence after primary anterior shoulder dislocation.JSES international · 2025Article
- Glenoid track and subcritical Hill-Sachs lesion.JSES international · 2024Review
- Bipolar bone loss and distance to dislocation.Annals of joint · 2024Review
- First-time traumatic anterior shoulder dislocation: Approach for the primary health care physician.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2023Article
- Return to Preinjury-Level Sports After Arthroscopic Latarjet for Recurrent Anterior Shoulder Instability in Professional Athletes.Orthopaedic journal of sports medicine · 2023Article
- Combined Double-Pulley Remplissage and Bankart Repair.Arthroscopy techniques · 2022Article
- With the exception of the Hill-Sachs interval, CT and MRI show no significant differences in the diagnostic value of the HSL measurement regardless of the measurement technique.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2021Article
- Evolving concepts and consensus in challenging shoulder problems: a European perspective.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2021Article
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Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe purpose of this study was to evaluate whether the presence of an off-track Hill-Sachs lesion has an impact on the recurrence rate after nonoperative management of first-time anterior shoulder dislocations.
methodsA retrospective cohort study was planned with a follow-up via questionnaire after a minimum of 24 months. Fifty four patients were included in the study (mean age: 29.5 years; 16 female, 38 male). All of these patients opted for primary nonoperative management after first-time traumatic anterior shoulder dislocation, in some cases even against the clinician's advice. The glenoid track and the Hill-Sachs interval were evaluated in the MRI scans. The clinical outcome was evaluated via a shoulder-specific questionnaire, ASES-Score and Constant Score. Further, patients were asked to report on recurrent dislocation (yes/no), time to recurrent dislocation, pain, feeling of instability and satisfaction with nonoperative management.
resultsIn 7 (13%) patients, an off-track Hill-Sachs lesion was present, while in 36 (67%) the lesion was on-track and 11 (20%) did not have a structural Hill-Sachs lesion at all. In total, 31 (57%) patients suffered recurrent dislocations. In the off-track group, all shoulders dislocated again (100%), while 21 (58%) in the on-track group and 3 (27%) in the no structural Hill--Sachs lesion group had a recurrent dislocation, p = 0.008. The mean age in the group with a recurrence was 23.7 ± 10.1 years, while those patients without recurrent dislocation were 37.4 ± 13.1 years old, p < 0.01. The risk for recurrence in patients under 30 years of age was higher than in those older than 30 years (OR = 12.66, p < 0.001). There were no significant differences between patients with on- and off-track lesions regarding patients' sex, height, weight and time to reduction and glenoid diameter. Off-track patients were younger than on-track patients (24.9 ± 7.3 years vs. 29.6 ± 13.6 years). However, this difference was not statistically significant.
conclusionThe presence of an off-track Hill-Sachs lesion leads to significantly higher recurrence rates compared to on-track or no structural Hill--Sachs lesions in patients with nonoperative management and should be considered when choosing the right treatment option. Therefore, surgical intervention should be considered in patients with off-track Hill-Sachs lesions. LEVEL OF EVIDENCE: IV.
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