Humeral Avulsion of Glenohumeral Ligament Lesion (HAGL Lesion)

Abstract

Besides the Bankart lesion as the most common injury pattern after shoulder dislocation, the anterior or posterior detachment of the inferior capsule from the humeral head has come into the focus of shoulder surgery. As it is a rare lesion, the surgeon has to be aware of the existence of a so-called HAGL lesion. The combination of a symptomatic chronic shoulder instability or failed repair with a high number of dislocations and a typical MRI (Magnetic Resonance Imaging) with a J-shaped form of the inferior capsule leads to the possible diagnosis of HAGL which can be verified during arthroscopy and in most cases treated simultaneously with reattaching the capsule to the humeral bone using small bone anchors. Open surgery is equally used. The operation is technically demanding, and the small series published in the literature promise good clinical results. Acute HAGL lesions have a high rate of healing potency and can therefore be treated conservatively.