[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-451094-105":59,"doc-detail-451094-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","treatment-of-engaging-reverse-hill-sachs-lesions-with-press-fit-large-fresh-osteochondral-allografts-a-technical-note","Treatment of engaging reverse Hill-Sachs lesions with press-fit large fresh osteochondral allografts: a technical note","","Technical note describing osteochondral allograft transfer for engaging reverse Hill-Sachs lesions (RHSLs) causing locked or recurrent posterior shoulder instability. RHSLs are discussed as impaction fractures of the anteromedial humeral head against the posterior glenoid rim, with emphasis on early assessment to limit recurrent dislocation and joint deterioration. The note contrasts arthroscopic repair, autografts, McLaughlin-type advancement, balloon humeroplasty, and humeral arthroplasty with limitations, then details press-fit implantation planning and a described surgical workflow.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/treatment-of-engaging-reverse-hill-sachs-lesions-with-press-fit-large-fresh-osteochondral-allografts-a-technical-note/451094/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/treatment-of-engaging-reverse-hill-sachs-lesions-with-press-fit-large-fresh-osteochondral-allografts-a-technical-note/451094.png","ImageObject",300,407,{"name":92,"@type":93},"Chumphorn","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-03","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":34},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What clinical situation does this osteochondral allograft technique target for reverse Hill-Sachs lesions?","Question",{"text":112,"@type":113},"It is indicated for patients with locked or recurrent posterior shoulder instability with a large engaging RHSL involving less than half of the humeral head articular surface. Larger lesions may require hemiarthroplasty options.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What contraindications are listed for OC allograft reconstruction in this technical note?",{"text":117,"@type":113},"Advanced osteoarthritis and infection are contraindications. Relative contraindications include untreated seizure disorders and prior McLaughlin procedures where the subscapularis attachment is contained within the RHSL defect.",{"name":119,"@type":110,"acceptedAnswer":120},"How is preoperative planning performed before press-fit osteochondral allograft implantation?",{"text":121,"@type":113},"Preoperative imaging, including CT with 3-dimensional reconstruction, is reviewed to assess RHSL size and to measure anticipated graft depth, width, and radius of curvature for graft selection and planning.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},451094,1790785393,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":34,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":34,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},2336475401981,"https://ap-avatar.wpscdn.com/avatar/22000c94efd8d5204d?x-image-process=image/resize,m_fixed,w_180,h_180&k=1786935347598174694","JS ES R E V I E W S , R E P O R T S , A N D T E C H N I QU E S 6 (2026) 100620  \nAvailable online [at](at www.sciencedirect.com)[ www.sciencedirect.com](at www.sciencedirect.com)  \nScienceDirect  \n[www.jsesreviewsreportstech.org](www.jsesreviewsreportstech.org)  \nTreatment of engaging reverse Hill-Sachs lesions with press-fit large fresh osteochondral allografts: a technical note  \nJamal Zahir, BS, Kassem Ghayyad, MD, Daniel Goltz, MD, and G. Russell Huffman, MD, MPH, FAAOS *  \nRothman Orthopaedics Florida at AdventHealth, Orlando, FL, USA  \nA R T I C L E I N F O  \nKeywords:  \nReverse Hill-Sachs lesion Osteochondral allograft transfer Shoulder instability  \nPress-fit  \nLevel of evidence: Technical Note  \nReverse Hill-Sachs lesions (RHSLs) are characterized by an impaction fracture of the anteromedial humeral head as it strikes the posterior glenoid rim.8 Classically, RHSL's result from posterior dislocation during seizures of electrocution but may also occur from trauma, falls on outstretched arms, athletics, or repetitive injuries.22 In cases of acute posterior glenohumeral dislocation, RHSLs occur in up to 90% of patients, although their shape and size can differ depending on the force of the injury. Of these, approximately one-third goon to develop recurrent shoulder dislocations and instability.3 Thus, careful assessment and early treatment is crucial for preventing both further joint deterioration and recurrent locked dislocations. Common techniques to address RHSLs include arthroscopic repair, autograft filling of the defect,  \nballoon humeroplasty, and the open and modified “arthroscopic” McLaughlin advancement of the lesser tuberosity and subscapularis (SS), respectively, into the defect. For cases involving greater than 50% of the humeral articular diameter, humeral arthroplasty may be warranted. Both arthroscopy and balloon humeroplasty offer advantages due to their lessinvasive nature, whereas autografts significantly reduce the risk of graft rejection. However, each of these techniques have notable limitations: arthroscopic repair maybe insufficient for larger lesions; autografts carry the risk of donor site morbidity, and in the case of the McLaughlin procedure, constrained kinematics; and balloon humeroplasty may fail to restore the morphology fully and does not restore articular cartilage integrity, potentially leading to early-onset arthritis and glenohumeral incongruency.2,20,21 Recently, osteochondral (OC) allografts have emerged as viable ways to address the limitations above, particularly as fresh bulk allografts have become increasingly available with improving procurement times. With this increased adoption, a growing literature has reported favorable clinical and functional outcomes.1,4,8 For patients indicated for OC allografting, the procedure typically involves defect sizing and preparation, followed by graft sizing, preparation, and press-fit implantation. This technique offers several advantages, including the elimination of donor site morbidity and restoration of articular cartilage congruency. Moreover, the uniqueness of our technique is in the  \nInstitutional review board approval was not required for this technical note.  \n*Corresponding author: G. Russell Huffman, MD, MPH, FAAOS, Rothman Orthopaedics Florida at AdventHealth, 265 E. Rollins St Innovation Tower, Suite 11, Orlando, FL 32804, USA.  \nE-mail address: [grussellhuffman@outlook.com](grussellhuffman@outlook.com) (G.R. Huffman) .  \n[https://doi.org/10.1016/j.xrrt.2025.100620](https://doi.org/10.1016/j.xrrt.2025.100620)  \n2666-6391/© 2025 The Authors. Published by Elsevier Inc. on behalf of American Shoulder and Elbow Surgeons. This is an open access article under the CC BY-NC-ND license ([http://creativecommons.org/licenses/by-nc-nd/4.0/](http://creativecommons.org/licenses/by-nc-nd/4.0/)) .  \nFigure 1 — Patient A- (A) Axial computed tomography (CT) scan example of a right shoulder demonstrating a large RHSL (yellow asterisk) (25 mm width","cbCaikSf60m7DsgE","https://ap.wps.com/l/cbCaikSf60m7DsgE","pdf",5623946,"English","# Surgical technique\n## Indications and contraindications\n## Step 1: surgical preparation and equipment","[{\"question\":\"What clinical situation does this osteochondral allograft technique target for reverse Hill-Sachs lesions?\",\"answer\":\"It is indicated for patients with locked or recurrent posterior shoulder instability with a large engaging RHSL involving less than half of the humeral head articular surface. Larger lesions may require hemiarthroplasty options.\"},{\"question\":\"What contraindications are listed for OC allograft reconstruction in this technical note?\",\"answer\":\"Advanced osteoarthritis and infection are contraindications. Relative contraindications include untreated seizure disorders and prior McLaughlin procedures where the subscapularis attachment is contained within the RHSL defect.\"},{\"question\":\"How is preoperative planning performed before press-fit osteochondral allograft implantation?\",\"answer\":\"Preoperative imaging, including CT with 3-dimensional reconstruction, is reviewed to assess RHSL size and to measure anticipated graft depth, width, and radius of curvature for graft selection and planning.\"}]","Treatment of engaging reverse Hill-Sachs lesions with press-fit large fresh osteochondral allografts: a technical note | PDF",1790734362,18]