Articular arc length mismatch as a cause of failed bankart repair.

The purpose of this article is to recognize an often overlooked cause of failed anterior stabilization procedures of the shoulder. Hill-Sachs lesions are common occurrences after anterior dislocation. But despite the frequency of occurrence, they are commonly not addressed in the treatment of recurrent anterior dislocation. The Hill-Sachs lesion produces a shortened rotational arc length of the humeral head on the glenoid; any engagement of the defect with the glenoid produces a sensation in the patient of subluxation/dislocation. However, instead of subluxation/dislocation, the sensation may be caused by mismatch between the articular arc length of the humeral head and the glenoid. The literature concerning the Hill-Sachs lesion and its association with recurrent dislocation has been reviewed. There is no recognition in the literature of this articular arc length mismatch as a cause of failed anterior stabilization procedures. We present a case in which a Hill-Sachs lesion was the cause of a perceived recurrent subluxation/dislocation of the shoulder.