Paper 05: Inferior Hill-Sachs Position Predicts Failure Following Primary Bankart Repair for On-Track Lesions

Objectives: The on-track/off-track concept for shoulder instability primarily describes the medial-lateral rotational relationship between an engaging Hill-Sachs lesion and a Bankart defect. Though clinically more protective, on-track lesions retain some risk failure following primary arthroscopic repair. While of this can be explained by “near-track” concept, role superior-inferior position has never been studied in context This study aims to identify bankart Our hypothesis is that inferiorly-based may engage with arm neutral thus higher Methods: We performed retrospective analysis 201 individuals on track who underwent repair (without remplissage) 2007 2019 have minimum 2 year follow-up. Patients were defined as those sustained dislocation or subluxation after index procedure. A pre-operative sagittal MRI cut showing maximum diameter was used analysis. Sagittal angle formed bisecting line through humeral head center, against mid-humeral axis (Figure 1); example, 0 twelve o’clock head, while 90 equatorial. priori four quadrants semi-quantitative analysis, based physiologic positions: Superior (angle < 40), Mid-Superior (40-60), Mid (61-90), Inferior (>90). then correlated Results: Failure rates it relates follows (Table 1): No (10 73, 13.7%), (0 7, 0%), mid-superior (6 36, 16.7%), (19 71, 26.8%), (1 6, 16.7%). grouped into low grade (No Hill-Sachs, Superior, quadrants) high (Mid quadrants). Low represented 13.8% failure, High 26% (p=0.034). Conclusions: contribute lesions. Inferiorly-based engagement at lower degrees abduction, our represent nearly double compared superior positions. [Table: see text]