title: Percutaneous balloon humeroplasty for Hill-Sachs lesions: a novel technique.
abstract: BACKGROUND
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Orthopaedics, University of Cincinnati, Cincinnati, OH 45267, USA. stachorz@ucmail.uc.edu
authors.forename: Rafal Z
authors.initials: RZ
authors.lastname: Stachowicz
authors.forename: James R
authors.initials: JR
authors.lastname: Romanowski
authors.forename: Robert
authors.initials: R
authors.lastname: Wissman
authors.forename: Keith
authors.initials: K
authors.lastname: Kenter
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002102:Cadaver; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D058430:Humeral Head / Q000601:surgery*; D007593:Joint Instability / Q000209:etiology / Q000517:prevention & control*; D058498:Kyphoplasty / Q000295:instrumentation*; D008875:Middle Aged; D012783:Shoulder Dislocation / Q000209:etiology / Q000517:prevention & control*; D012784:Shoulder Fractures / Q000150:complications / Q000601:surgery*
keywords: Basic Science; Cadaver Model; Hill-Sachs lesion; Surgical Technique; anterior shoulder dislocation; balloon humeroplasty; glenohumeral dislocation; inflatable bone tamp; shoulder