抄録
The purpose of this study was to clarify the postoperative changes of Hill-Sachs lesions (HSL) in patients with traumatic anterior shoulder instability and the relevant factors. We studied 39 shoulders of 37 patients (20 males and 17 females) who underwent anterior shoulder reconstruction for a traumatic anterior shoulder instability. The mean age at operation was 25.4 years (15-45). CT arthrography (CTA) was performed within 3 months before surgery and on average of 38 months (12-87) after surgery. The length, width, and depth of HSL were compared on preoperative and postoperative CTA images. In addition, the factors related to the changes of HSL were analyzed, including the lesion size, the age at operation, the follow-up period, the period from initial dislocation to operation, the clinical outcome by Rowe' s criteria, and the postoperative ROM and activity (the t-test and χ2-test were used). There was a decrease in the size of HSL in 22 shoulders (including a complete disappearance in 3shoulders)(reduction group). We found no reduction of HSL in 17 shoulders (non-reduction group). The age at operation (21.2 vs.30.8 years) and the period from initial dislocation to operation (39 vs.125 months) were significantly different between the reduction and non-reduction groups (p<0.01). In conclusion, we detected a reduction of HSL in 56% of the patients on postoperative CTAs. The age at the operation and the period from the initial dislocation to the operation were significant determinants of the improvement of HSL. Their HSL is common for young patients who receive early shoulder stabilization to improve.
