Abstract
We described the evaluations for diagnosis by images and the surgical outcome of HAGL lesion. We reviewed 6 cases (6 males) of HAGL lesion out of 225 cases of traumatic anterior shoulder instability on whom we performed surgical treatment at our institutions from March 2001 to March 2005. The mean age at the time of operation was 24.8 years old (range 17-36 years old) and the mean of follow-up after surgery was 18.2 months (range 12-24 months). All cases had been involved in an athletic activity. All cases had undergone MR arthrography (MRA) before arthroscopy. The criterias for the preoperative diagnosis of an HAGL lesion on MRA were to detect the dilation of the axillary pouch on the oblique coronal image and the disrupted edge of the capsule on the axial image and in the ABER position. Finally we diagnosed using arthroscopy. In the treatment, open repair using suture anchors was performed. We evaluated the preoperative diagnosis by MRA, the JSS Shoulder Instability and Rowe's Score. All cases of HAGL lesion could be detected by MRA preoperatively. All cases returned to their preoperative sports level from 6 to 10 months (mean 7.2 months) after. The mean JSS shoulder Instability Score and Rowe's Score had improved from 54.3 and 24.2 points preoperatively to 98.1and 97.5 at the time of final investigation. The preoperative diagnosis of HAGL lesion by MRA was possible, and we could have a good clinical outcome with an open repair using suture anchors.
