Fresh Osteochondral Allograft to the Humeral Head for Treatment of an Engaging Reverse Hill-Sachs Lesion: Technical Case Report and Literature Review.

Posterior dislocation of the shoulder is rare, occurring in approximately 2% to 4% of all shoulder dislocations.18,32 Through a mechanism similar to that first characterized by Hill and Sachs,17 these dislocations have the potential to result in impaction fractures of the anterior aspect of the humeral head.32,33 These so-called reverse Hill-Sachs or McLaughlin26 lesions are estimated to occur in 86% of acute traumatic posterior shoulder dislocations35 and are often clinically significant, giving rise to persistent shoulder instability in approximately 35% of cases.32 An array of treatment options are described in the literature, dependent on factors including but not limited to the location, size, and scale of the defect; mechanism of recurrence; chronicity of the dislocation; and, importantly, the patient’s age, prior activity, and postoperative goals.