Typically, unstable shoulders are a result of a traumatic tear of the labrum off the shoulder socket. HAGL (Humeral attachment of the glenohumeral ligaments) lesions refer to a rarel pattern of shoulder instability in which the labrum remains attached to the socket and the ligaments actually tear directly under the ball. These types of injuries can be missed by the untrained eye both on MRI and intraoperatively. Failure to recognize this means failure to correct and, ultimately, failed treatment.
Surgical repair of these injuries is surgically delicate as the primary nerve to the shoulder can be at risk and, therefore, it has been recommended these be repaired through a more traditional, open incision. Dr. Bak has successfully treated many of these injuries through the open approach and, more recently, through a novel, arthroscopic repair technique in which the nerve is identified and protected during the repair process. While the repair technique differs dramatically from a standard repair, the recovery and success of this procedure is nearly identical to a standard shoulder instability repair.