Arthroscopic reconstruction of engaging reverse Hill-Sachs lesions

Background: Dorsal dislocation of the glenohumeral joint is rare and can lead to severe injuries. The extent of the reverse Hill-Sachs lesion (rHSL), in particular, plays a decisive role in the choice of therapy. Objective: The aim of this retrospective case analysis was to evaluate our own approach to treat patients with traumatic dorsal humeral head dislocation and rHSL (gamma-angle > 90(degrees)) and to analyze the results based on subjective functional parameters. Materials and methods: Five of the 7 patients who underwent surgery between 2020 and 2023 were included in the study. Subjective assessments of shoulder function, the American Shoulder and Elbow Surgeons Score (ASES), the Western Ontario Shoulder Instability Index (WOSI), return to activity and sports, and recurrent dislocations were recorded. Preoperative imaging was used to determine the alpha, beta and gamma angles of the rHSL and concomitant lesions. Results: Patients showed high satisfaction (subjective shoulder value [SSV]: mean 89) and a subjectively very good shoulder function (ASES: mean 95.6). The WOSI revealed a mean score of 30.3 points. Return to activity took an average of 3.2 weeks and to sports 4.8 months. No patient experienced recurrent dislocation. Conclusion: The results show good short-term outcomes for the joint-preserving treatment of posterior shoulder dislocation with rHSL.