Fresh Osteochondral Allograft (Humeral Head) for Treatment of an Engaging Reverse Hill-Sachs Lesion

Purpose: To report the results of using a fresh humeral head allograft to treat an engaging reverse Hill-Sachs lesion of the shoulder.


  • Historically, the use of a fresh osteochondral allograft has not been a popular treatment measure for reverse Hill-Sachs lesions
  • A 24-year-old male sustained a shoulder injury after being struck by a car while on his bicycle
  • The humeral impaction measured approximately 2 cm in width and 5 mm deep through MRI
  • An 18 mm dowel prepared from a fresh humeral head allograft was transplanted into the injury using a press-fit application
  • At 20 weeks, his active range of motion was within normal limits and was equal to the unaffected shoulder
  • The patient had complete resolution of shoulder pain and full return to work activity with only mild occasional stiffness.

JRF Ortho Take Away: When appropriate, surgeons should consider osteochondral allograft as a treatment method, particularly in younger active patients. In this case it was able to biologically reconstruct the anatomy while also improving pain and function.

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Authors: Loren O. Black, Jai-Wei Kevin Ko, Samantha M. Quilici and Dennis C. Crawford

Published: The Orthopaedic Journal of Sports Medicine

Level of Evidence: IV