The purpose of this article is to recognize an often overlooked cause of fa
iled anterior stabilization procedures of the shoulder. Hill-Sachs lesions
are common occurrences after anterior dislocation. But despite the frequenc
y of occurrence, they are commonly not addressed in the treatment of recurr
ent anterior dislocation. The Hill-Sachs lesion produces a shortened rotati
onal are length of the humeral head on the glenoid; any engagement of the d
efect with the glenoid produces a sensation in the patient of subluxation/d
islocation. However, instead of subluxation/dislocation, the sensation may
be caused by mismatch between the articular are length of the humeral head
and the glenoid, The literature concerning the Hill-Sachs lesion and its as
sociation with recurrent dislocation has been reviewed. There is no recogni
tion in the literature of this articular are length mismatch as a cause of
failed anterior stabilization procedures. We present a case in which a Hill
-Sachs lesion was the cause of a perceived recurrent subluxation/dislocatio
n of the shoulder.