What is the treatment for an engaging Hill-Sachs lesion?

An engaging Hill-Sachs lesion is a compression fracture of the humeral head that occurs during an anterior shoulder dislocation. The term "engaging" signifies that the lesion comes into contact with the glenoid rim, potentially leading to recurrent dislocations.

Remplissage is considered an appropriate treatment for engaging Hill-Sachs lesions because it aims to fill the defect with soft tissue, which can help stabilize the humeral head and prevent further dislocations. This procedure typically involves the transfer of the infraspinatus tendon into the defect, creating a cushion that limits the interaction between the humeral head and the glenoid rim during shoulder motion.

Other treatment options, while relevant in different contexts, do not directly address the specific issues posed by an engaging Hill-Sachs lesion. Arthrodesis would create a rigid fixation of the shoulder joint, which is not typically recommended for active patients; open reduction focuses more on realigning dislocated bones rather than addressing the defect itself; and debridement might only remove damaged tissue without reinforcing the stability needed for the Hill-Sachs lesion. Therefore, Remplissage stands out as the most effective treatment for this specific condition.