APEX Shoulder Mastering Surgical Techniques for Clinical Success-GAGHL, HAGL, and RHAGL’s

GAGHL, HAGL, and RHAGL’s_ Fixing Them Safely

Video Transcription

Video Summary

JT Tokish from Mayo Clinic discusses shoulder instability caused not just by the typical Bankart lesion but also by a humeral-sided ligament tear called a Hagel, occurring in about 9-10% of cases. Risk factors include hyperabduction and slow loading injuries, common in wrestlers and rock climbers. Diagnosis relies on history, physical exam noting pain and apprehension, and MRI—though chronic cases may be missed preoperatively. Surgical repair involves arthroscopic reattachment of the ligament to the humeral head, with care to avoid the nearby axillary nerve. Outcomes are generally positive, and sometimes a mini-open approach is recommended for safety.

Asset Caption

John Tokish, MD

Keywords

shoulder instability

Bankart lesion

humeral-sided ligament tear

Hagel lesion

arthroscopic repair