RESEARCH & ARTICLES

Reverse Hill-Sachs and Hill-Sachs Lesion Repair with Fresh Talus Osteochondral Allograft: A Series of 3 Patients

Purpose: To evaluate the feasibility and clinical outcomes of using fresh talus osteochondral allografts to repair large engaging Hill-Sachs and reverse Hill-Sachs lesions in patients with recurrent shoulder instability.

Summary:

• This case series outlines the surgical technique for using talus allografts in the treatment of Hill-Sachs and reverse Hill-Sachs lesions.
• At one-year follow-up, all patients reported minimal pain and no recurrence of glenohumeral instability.
• Follow-up imaging confirmed successful graft incorporation in both lesion types, with no evidence of graft resorption, failure, osteonecrosis, or collapse.

JRF Takeaways: With dense subchondral bone and thick articular cartilage, talus grafts offer surgeons a alternative osteochondral allograft option with a suitable radius of curvature for effective treatment of both Hill-Sachs and reverse Hill-Sachs lesions. These grafts are typically readily available without the need for precise size matching.

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Authors: Kelsey Martin, DO, Isaiah Hughes, BS, Haley Tornberg, BS, Deep Patel, MD, Parker Johnsen, MD, Matthew T. Kleiner, MD, Catherine J. Fedorka, MD

Published: JBJS Case Connector

Institution: Cooper University Hospital, Camden, New Jersey, U.S.A.