Hill-Sachs Lesion

A Hill-Sachs lesion is a compression fracture defect on the posterolateral humeral head that occurs when the humeral head impacts the glenoid rim during an anterior shoulder dislocation. It is often found alongside a Bankart lesion and can contribute to ongoing instability if the defect is large.

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Typical Recovery Time

5–6 months post-surgery

Symptoms

•History of shoulder dislocation
•Clicking or catching in external rotation
•Apprehension with arm in abduction and external rotation
•Instability episodes during overhead activity
•Pain with specific arm positions

Common Causes

•Anterior shoulder dislocation causing humeral head impaction
•Recurrent dislocations increasing defect size
•High-energy trauma
•Contact sports collision

Treatment Options

1Observation for small, non-engaging lesions

2Bankart repair for associated soft tissue injury

3Remplissage procedure to fill the defect

4Bone grafting (allograft or iliac crest) for large lesions

5Latarjet procedure when combined with bone loss

When to See a Doctor

Imaging evaluation (CT or MRI) after any shoulder dislocation helps determine the size and clinical significance of a Hill-Sachs defect.

Frequently Asked Questions

What is a Hill-Sachs lesion?

A Hill-Sachs lesion is a dent or compression injury in the ball of the shoulder joint. It usually happens during a shoulder dislocation. The injury can contribute to ongoing shoulder instability.

What causes a Hill-Sachs lesion?

It is most commonly caused by an anterior shoulder dislocation. When the shoulder comes out of place, the ball of the joint can impact the edge of the socket. Contact sports, falls, and traumatic injuries increase the risk.

What are the symptoms?

Symptoms are often related to shoulder instability rather than the bone injury itself. Patients may feel pain, weakness, or fear that the shoulder will slip out again. Some have repeated dislocations or subluxations.

Do I need surgery for a Hill-Sachs lesion?

Treatment depends on the size of the lesion and whether the shoulder remains unstable. Physical therapy may be enough for smaller injuries with good stability. Surgery may be needed for recurrent instability or larger lesions.

When can I return to sports?

Return to sports depends on stability, strength, and the risk of another dislocation. Non-contact athletes may return sooner than collision athletes. A guided rehab plan is important before returning to full play.

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