3-D Modeling of Humeral Head Defects in Glenohumeral Instability: Clinical Implications of Lesion Morphology and the Glenoid Track Concept

Hill–Sachs lesion measurement with tridimensional models in anterior shoulder instability

“…The studies by Burkhart and De Beer 3 in the 2000s rekindled the interest in the HS lesion, followed by the concept of glenoid track, or the “trail” that the glenoid makes on the humeral head during abduction and lateral rotation of the shoulder, as studied by Iyengar et al 10 and Yamamoto et al 5 This concept was extended in 2014 by Giacomo et al, 6 in an article describing a method to determine whether a lesion would be on track or off track, and its correspondence with glenoid edge injuries and lesion recurrence. In that specific study, the authors propose a method to measure the diameter of the glenoid and determine the size of the HS lesion, which are fundamental for the presented concepts to be applied and, thus, to guide the treatment of the recurrent anterior lesion.…”

“…The authors proposed that this assessment could be performed three-dimensionally. The study by Iyengar et al 10 determined that 3-D computed tomography reconstruction of the HS lesion is the gold standard for determining its volume.…”

“…Three-dimensional (3-D) reconstructions using computerized tomography are currently recommended to more accurately characterize HS lesions regarding their size, orientation, and morphology. With this type of examination, in 2014 Iyengar et al 10 demonstrated that larger and more horizontal lesions tend to present a higher engagement. Other authors use software to measures the HS lesion from sagittal, coronal, and axial cuts, as well as from 3-D computed tomography reconstructions.…”