title: Hill-Sachs Off-track Lesions as Risk Factor for Recurrence of Instability After Arthroscopic Bankart Repair.
abstract: To evaluate the effect of "off-track" Hill-Sachs lesions, according to the glenoid track concept, as a risk factor for recurrent instability and need for revision surgery after arthroscopic Bankart repair.
  
  
  
  We retrospectively reviewed 254 patients with anteroinferior glenohumeral instability who were managed with an arthroscopic stabilization procedure between 2006 and 2013. Preoperative magnetic resonance imaging and/or computed tomography scans were available for 100 of these patients to calculate the glenoid track and the presence of "on-track" or off-track Hill-Sachs lesions. Recurrence of instability was evaluated at a mean follow-up of 22.4 months.
  
  
  
  Of 100 patients whose magnetic resonance imaging and/or computed tomography scans were available, 88 had an on-track Hill-Sachs lesion and 12 had an off-track Hill-Sachs lesion. Revision surgery for recurrent instability was performed in 5 patients (6%) with an on-track Hill-Sachs lesion and in 4 patients (33%) with an off-track Hill-Sachs lesion (odds ratio, 8.3; 95% confidence interval, 1.85-37.26; P = .006).
  
  
  
  An off-track Hill-Sachs lesion is a significant and important risk factor for recurrence of instability and need for revision surgery after arthroscopic Bankart repair when compared with an on-track Hill-Sachs lesion.
  
  
  
  Level IV, prognostic case series.
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Rome, Italy; Department of Orthopaedic Sports Medicine, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
authors.forename: Joel
authors.initials: J
authors.lastname: Locher
authors.affiliation: Department of Orthopaedic Sports Medicine, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
authors.forename: Frauke
authors.initials: F
authors.lastname: Wilken
authors.affiliation: Department of Orthopaedic Sports Medicine, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
authors.forename: Knut
authors.initials: K
authors.lastname: Beitzel
authors.affiliation: Department of Orthopaedic Sports Medicine, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Buchmann
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Rome, Italy.
authors.forename: Umile Giuseppe
authors.initials: UG
authors.lastname: Longo
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Rome, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Denaro
authors.affiliation: Department of Orthopaedic Sports Medicine, Klinikum rechts der Isar, Technische Universität München, Munich, Germany. Electronic address: imhoff@tum.de.
authors.forename: Andreas B
authors.initials: AB
authors.lastname: Imhoff
mesh_terms: D000293:Adolescent; D000328:Adult; D001182:Arthroscopy / Q000379:methods*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000175:diagnosis / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology*; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D055815:Young Adult