A 25-year-old rugby player is tackled and sustains anterior shoulder dislocation. Which of the following is the most common pathological lesion underlying recurrent anterior instability?

• A Bankart lesion (avulsion of anteroinferior labrum and glenohumeral ligament) ✓
• B Hill-Sachs lesion (compression fracture of posterolateral humeral head)
• C HAGL lesion (humeral avulsion of glenohumeral ligament)
• D Rotator cuff tear

Explanation

The Bankart lesion — detachment of the anteroinferior glenoid labrum and inferior glenohumeral ligament complex from the glenoid rim — is the essential pathology in 85–97% of cases of traumatic anterior glenohumeral instability. It occurs as the humeral head displaces anteroinferiorly and shears off the labrum. Hill-Sachs lesion (posterolateral head impaction) is commonly associated but is a secondary bony lesion. HAGL lesion is an uncommon variant where the ligament avulses from its humeral attachment. Bankart repair (arthroscopic or open Latarjet) addresses the primary pathology.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

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Written and medically reviewed by the StethoPrep medical team.