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

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. Level of evidence: Basic Science, Surgical Technique, Cadaver Model. (C) 2013 Journal of Shoulder and Elbow Surgery Board of Trustees.