{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:20:40Z","timestamp":1787066440918,"version":"build-2736575974"},"reference-count":29,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2020,8,1]],"date-time":"2020-08-01T00:00:00Z","timestamp":1596240000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2020,8,1]],"date-time":"2020-08-01T00:00:00Z","timestamp":1596240000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2020,8,1]],"date-time":"2020-08-01T00:00:00Z","timestamp":1596240000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The purpose of this study was to evaluate whether the presence of an off\u2010track Hill\u2013Sachs lesion has an impact on the recurrence rate after nonoperative management of first\u2010time anterior shoulder dislocations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study was planned with a follow\u2010up via questionnaire after a minimum of 24\u00a0months. Fifty four patients were included in the study (mean age: 29.5 years; 16 female, 38\u00a0male). All of these patients opted for primary nonoperative management after first\u2010time traumatic anterior shoulder dislocation, in some cases even against the clinician\u2019s advice. The glenoid track and the Hill\u2013Sachs interval were evaluated in the MRI scans. The clinical outcome was evaluated via a shoulder\u2010specific questionnaire, ASES\u2010Score and Constant Score. Further, patients were asked to report on recurrent dislocation (yes\/no), time to recurrent dislocation, pain, feeling of instability and satisfaction with nonoperative management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In 7 (13%) patients, an off\u2010track Hill\u2013Sachs lesion was present, while in 36 (67%) the lesion was on\u2010track and 11 (20%) did not have a structural Hill\u2013Sachs lesion at all. In total, 31 (57%) patients suffered recurrent dislocations. In the off\u2010track group, all shoulders dislocated again (100%), while 21 (58%) in the on\u2010track group and 3 (27%) in the no structural Hill\u2010\u2013Sachs lesion group had a recurrent dislocation,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.008. The mean age in the group with a recurrence was 23.7\u2009\u00b1\u200910.1 years, while those patients without recurrent dislocation were 37.4\u2009\u00b1\u200913.1 years old,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01. The risk for recurrence in patients under 30 years of age was higher than in those older than 30 years (OR\u2009=\u200912.66,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                    <jats:p>There were no significant differences between patients with on\u2010 and off\u2010track lesions regarding patients\u2019 sex, height, weight and time to reduction and glenoid diameter. Off\u2010track patients were younger than on\u2010track patients (24.9\u2009\u00b1\u20097.3 years vs. 29.6\u2009\u00b1\u200913.6 years). However, this difference was not statistically significant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The presence of an off\u2010track Hill\u2013Sachs lesion leads to significantly higher recurrence rates compared to on\u2010track or no structural Hill\u2013\u2010Sachs lesions in patients with nonoperative management and should be considered when choosing the right treatment option. Therefore, surgical intervention should be considered in patients with off\u2010track Hill\u2013Sachs lesions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of evidence<\/jats:title>\n                    <jats:p>IV<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00167-020-06176-1","type":"journal-article","created":{"date-parts":[[2020,8,1]],"date-time":"2020-08-01T05:13:51Z","timestamp":1596258831000},"page":"2289-2296","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Off\u2010track Hill\u2013Sachs lesions predispose to recurrence after nonoperative management of first\u2010time anterior shoulder dislocations"],"prefix":"10.1002","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2078-2241","authenticated-orcid":false,"given":"Felix G. E.","family":"Dyrna","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Trauma, Hand and Reconstructive Surgery University Hospital M\u00fcnster Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marius","family":"Ludwig","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> Department of Orthopaedic Sportsmedicine Technical University Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas B.","family":"Imhoff","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> Department of Orthopaedic Sportsmedicine Technical University Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Martetschl\u00e4ger","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> Department of Orthopaedic Sportsmedicine Technical University Munich Germany"},{"name":"<!--<label>3<\/label>--> German Center for Shoulder Surgery ATOS Clinic Munich Effnerstra\u00dfe 38 81925 M\u00fcnchen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,8]]},"reference":[{"key":"e_1_2_7_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546515574677"},{"key":"e_1_2_7_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00113\u2010004\u20100757\u20103"},{"key":"e_1_2_7_4_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623\u2010200608000\u201000010"},{"key":"e_1_2_7_5_2","doi-asserted-by":"publisher","DOI":"10.1053\/jars.2000.17715"},{"key":"e_1_2_7_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2013.10.004"},{"key":"e_1_2_7_7_2","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.14.14266"},{"key":"e_1_2_7_8_2","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.11.7639"},{"key":"e_1_2_7_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/036354658201000301"},{"key":"e_1_2_7_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010015\u20103980\u20102"},{"key":"e_1_2_7_11_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623\u2010200001000\u201000005"},{"key":"e_1_2_7_12_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports\u20102017\u2010098539"},{"key":"e_1_2_7_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2004.09.018"},{"key":"e_1_2_7_14_2","doi-asserted-by":"publisher","DOI":"10.1177\/03635465020300010501"},{"key":"e_1_2_7_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10278\u2010012\u20109458\u20106"},{"key":"e_1_2_7_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010019\u201005391\u20109"},{"key":"e_1_2_7_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00068\u2010001\u20101070\u20102"},{"key":"e_1_2_7_18_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546517698692"},{"key":"e_1_2_7_19_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546515597668"},{"key":"e_1_2_7_20_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports\u20102014\u2010094342"},{"key":"e_1_2_7_21_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546509334591"},{"key":"e_1_2_7_22_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010019\u201005441\u20102"},{"key":"e_1_2_7_23_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546515570621"},{"key":"e_1_2_7_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1058\u20102746(09)80019\u20100"},{"key":"e_1_2_7_25_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623\u2010200611000\u201000002"},{"key":"e_1_2_7_26_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010019\u201005471\u2010w"},{"key":"e_1_2_7_27_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623\u2010200305000\u201000016"},{"key":"e_1_2_7_28_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301\u2010620X.86B1.13695"},{"key":"e_1_2_7_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2016.05.039"},{"key":"e_1_2_7_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2006.12.012"}],"container-title":["Knee 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November 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 June 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 August 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"The authors declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"No funding was received for this study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Funding"}},{"value":"It was approved by the IRB comittee and conducted according to the ethical guidlines.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent was achieved by each patient before inclusion.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}