Humeral head bone loss: what determines the approach for surgical treatment?

Hill-Sachs lesion is a common aftermath of a multiply anterior shoulder dislocations and a reason of chronic anterior instability. Even though there are a lot of studies on this topic, there are still some queries about treatment standards of Hill-Sachs lesion.In this study we reviewed the efficiency of routine diagnostic methods of Hill-Sachs lesion and formed indications for a surgical treatment. Showed a place for remplissage (infraspinatus tenodesis) in stabilization of a humerus head.Hill-Sachs Remplissage is the first arthroscopic method to directly solve the problem of Hill-Sachs lesion. Filling a bone defect in the depth of the Hill-Sachs lesion effectively compensates it and turns it into an extra-articular, thereby preventing the interaction of the front edge of the glenoid and the Hill-Sachs defect. It is inalienable to compare arthroscopic bone loss data with 3D-CT and MRI data for objective assessment and informed decision making. The area of the of the humeral head devoid of articular cartilage should not be confused with Hill-Sachs lesion - a normal anatomical condition with bone pathology. Significant postoperative complications were not noted, in particular, the premise that remission restricts external rotation did not materialize. This is an effective approach to a complex subgroup of patients with instability, which has significant potential for restoring normal function of the shoulder joint.