Case Highlights
Clinical indication: Recurrent anterior shoulder dislocations associated with a significant Hill-Sachs defect.
Custom solution: Development of patient-specific Hill-Sachs implant.
Surgical collaboration: Dr David Duckworth, Allegra Innovations and Jajal Medical.
Technology: Advanced CT imaging, 3D anatomical modelling and metal additive manufacturing.
Implant material: Medical-grade titanium (Ti6Al4V).
Clinical outcome: Successful implant placement with postoperative improvements in shoulder stability and range of motion.
Clinical Background
A male patient presented with a history of chronic anterior shoulder dislocations, resulting in significant structural damage to the humeral head. Advanced imaging identified a Hill-Sachs lesion, a characteristic indentation of the postero-superolateral humeral head associated with recurrent dislocation. A coexisting Bankart lesion affecting the glenoid rim was also suspected, further contributing to persistent joint instability.
Due to the depth and anatomical position of the bone defect, conventional treatment approaches were considered insufficient. A customised reconstruction was therefore pursued, bringing together the expertise of Allegra Innovations and Jajal Medical to develop an innovative patient-specific solution.
Patient-Specific Design and Surgical Planning
In collaboration with the Allegra Innovations team, Dr David Duckworth led the surgical planning process, supported by Jajal Medical's advanced design and engineering capabilities.
High-resolution CT scans were used to generate a detailed 3D anatomical model of the patient's shoulder. Through advanced segmentation and digital reconstruction, a bespoke implant was developed to replicate the natural curvature of the humeral head and precisely restore the missing bone structure.
This approach enabled the implant design to be tailored to the patient's individual anatomy, addressing the specific dimensions and geometry of the Hill-Sachs defect.
Advanced Manufacturing and Implant Design
The custom Hill-Sachs implant was produced using advanced metal 3D printing technology and medical-grade titanium alloy (Ti6Al4V). This material provides the mechanical strength, biocompatibility and durability required for orthopaedic applications.
The implant incorporated several specialised design features:
Patient-specific geometry: Precisely engineered curvature and thickness to correspond with the anatomical dimensions of the Hill-Sachs defect.
Porous lattice interface: An integrated porous structure at the bone interface, designed to support bone ingrowth and promote osseointegration.
Recessed locking screw mechanism: Provides secure fixation while minimising interference with the surrounding articular cartilage.
Mirror-polished articulating surface: Creates a smooth contact surface to facilitate joint articulation and preserve natural shoulder movement.
The combination of anatomical modelling, advanced implant engineering and additive manufacturing enabled the development of a highly customised reconstruction solution for a complex shoulder condition.
Surgical Outcome
The procedure was successfully completed, with the implant achieving a precise fit within the defect site. Postoperative assessments demonstrated a marked improvement in shoulder stability and range of motion.
Dr David Duckworth highlighted the clinical significance of this personalised solution, reinforcing the value of customised implant design and accurate preoperative planning when addressing complex shoulder pathologies.
This case demonstrates the potential of collaborative orthopaedic innovation, combining surgical expertise, advanced 3D planning and patient-specific implant manufacturing to address challenging anatomical defects where conventional solutions may be limited.