治療が必要な Hill-Sachs 損傷はどれくらいあるか？
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<B>Background:</B> A large Hill-Sachs lesion has been considered as a risk factor for postoperative recurrence. However, there are few reports describing the incidence of Hill-Sachs lesions that engage with the glenoid. The purpose of this study was to clarify the incidence of engaging Hill-Sachs lesions using a new concept of the glenoid track.<BR><B>Methods:</B> We retrospectively reviewed CT images of 74 patients with unilateral recurrent anterior dislocation (average age: 26 years old). The DICOM data were reconstructed to 1-mm-thick slices in the oblique coronal plane perpendicular to the line connecting the medial margin of the cuff attachment site. In these slices, we measured the maximum distance from the medial margin of the Hill-Sachs lesion to the medial margin of the footprint of the rotator cuff. The location of the Hill-Sachs lesion in the glenoid track was assessed.<BR><B>Results:</B> Among 74 shoulders, 70 shoulders showed Hill-Sachs lesions. The most medial margin of the Hill-Sachs lesion was located 14.2 ± 3.6 mm (mean ± SD) medial from the footprint, which was equivalent to 67% ± 19% of the glenoid track width. In four out of 70 cases with Hill-Sachs lesions (5.7%), the most medial margin of the Hill-Sachs lesion extended medially over the glenoid track.<BR><B>Discussion:</B> Burkhart et al. reported that the incidence of engaging Hill-Sachs lesion was 1.5%. In our series of 74 cases, the prevalence was 5.4%. Hill-Sachs lesions that need to be treated surgically are proved to be rare.
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- 治療が必要な Hill-Sachs 損傷はどれくらいあるか？