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Recurrent anterior shoulder dislocation with engaging Hill–Sachs defect: remplissage or Latarjet?

  • Original Article
  • Published:
European Orthopaedics and Traumatology

Abstract

Introduction

Burkhart and De Beer were the first to conclude that arthroscopic Bankart repair in the presence of engaging Hill–Sachs defect is likely to fail and requires open surgery. To prevent this engagement, the Hill–Sachs lesion can either be made extraarticular by arthroscopic posterior capsulodesis and infraspinatus tenodesis to fill (remplissage) the Hill–Sachs lesion in addition to an arthroscopic Bankart repair or the functional glenoid arc can be lengthened by a coracoid transfer procedure to make the defect non-engaging.

Objectives

The purpose of this study was to compare the clinical outcome and cost-effectiveness of arthroscopic remplissage versus open Latarjet procedure in cases of recurrent shoulder dislocation with large engaging Hill–Sachs lesion.

Patients and methods

This comparative prospective study was conducted on 32 patients with a mean age of 28.2 years. Odd number patients had a modified Latarjet procedure and even number patients had arthroscopic remplissage procedure with capsulolabral repair using four anchors.

Results

The mean follow-up period was 31.31 months. Rowe score increased from a mean of 28.75 to 84.62 in the Latarjet group and from a mean of 26.12 to 86.62 in the remplissage group. The difference had no statistical significance. The only limitation in range of motion for both groups was in external rotation in abduction. Cost of the implants was tenfold more for the remplissage group.

Conclusion

Open modified Latarjet and arthroscopic remplissage procedure with Bankart repair are equally effective in prevention of dislocation in patients with recurrent anterior shoulder dislocation and engaging Hill–Sachs lesion.

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References

  1. Calandra JJ, Baker CL, Uribe J (1989) The incidence of Hill-Sachs lesions in initial anterior shoulder dislocations. Arthroscopy 5(4):254–257

    Article  CAS  PubMed  Google Scholar 

  2. Haviv B, Mayo L, Biggs D (2011) Outcomes of arthroscopic “remplissage”: capsulotenodesis of the engaging large Hill-Sachs lesion. J Orthop Surg Res 6:29

    Article  PubMed Central  PubMed  Google Scholar 

  3. Leroux T, Bhatti A, Khoshbin A, Wasserstein D, Henry P, Marks P et al (2013) Combined arthroscopic Bankart repair and remplissage for recurrent shoulder instability. Arthroscopy 29(10):1693–1701

    Article  PubMed  Google Scholar 

  4. Burkhart SS, De Beer JF (2000) Traumatic glenohumeral bone defects and their relationship to failure of arthroscopic Bankart repairs: significance of the inverted-pear glenoid and the humeral engaging Hill-Sachs lesion. Arthroscopy 16(7):677–694

    Article  CAS  PubMed  Google Scholar 

  5. Kropf EJ, Sekiya JK (2007) Osteoarticular allograft transplantation for large humeral head defects in glenohumeral instability. Arthroscopy 23(3):322 e1–5

    Article  PubMed  Google Scholar 

  6. Sugaya H, Moriishi J, Dohi M, Kon Y, Tsuchiya A (2003) Glenoid rim morphology in recurrent anterior glenohumeral instability. J Bone Joint Surg Am 85-A(5):878–884

    PubMed  Google Scholar 

  7. Park MJ, Tjoumakaris FP, Garcia G, Patel A, Kelly JD (2011) Arthroscopic remplissage with Bankart repair for the treatment of glenohumeral instability with Hill-Sachs defects. Arthroscopy 27(9):1187–1194

    Article  PubMed  Google Scholar 

  8. Burkhart SS, De Beer JF, Barth JR, Cresswell T, Roberts C, Richards DP (2007) Results of modified Latarjet reconstruction in patients with anteroinferior instability and significant bone loss. Arthroscopy 23(10):1033–1041

    Article  PubMed  Google Scholar 

  9. Lynch JR, Clinton JM, Dewing CB, Warme WJ, Matsen FA 3rd (2009) Treatment of osseous defects associated with anterior shoulder instability. J Shoulder Elbow Surg 18(2):317–328

    Article  PubMed  Google Scholar 

  10. Provencher MT, Ghodadra N, LeClere L, Solomon DJ, Romeo AA (2009) Anatomic osteochondral glenoid reconstruction for recurrent glenohumeral instability with glenoid deficiency using a distal tibia allograft. Arthroscopy 25(4):446–452

    Article  PubMed  Google Scholar 

  11. Moros C, Ahmad CS (2009) Partial humeral head resurfacing and Latarjet coracoid transfer for treatment of recurrent anterior glenohumeral instability. Orthopedics 32(8)

  12. Kazel MD, Sekiya JK, Greene JA, Bruker CT (2005) Percutaneous correction (humeroplasty) of humeral head defects (Hill-Sachs) associated with anterior shoulder instability: a cadaveric study. Arthroscopy 21(12):1473–1478

    Article  PubMed  Google Scholar 

  13. Chapovsky F, Kelly JD (2005) Osteochondral allograft transplantation for treatment of glenohumeral instability. Arthroscopy 21(8):1007

    Article  PubMed  Google Scholar 

  14. Boons HW, Giles JW, Elkinson I, Johnson JA, Athwal GS (2013) Classic versus congruent coracoid positioning during the Latarjet procedure: an in vitro biomechanical comparison. Arthroscopy 29(2):309–316

    Article  PubMed  Google Scholar 

  15. Ladermann A, Lubbeke A, Stern R, Cunningham G, Bellotti V, Gazielly DF (2013) Risk factors for dislocation arthropathy after Latarjet procedure: a long-term study. Int Orthop 37(6):1093–1098

    Article  PubMed Central  PubMed  Google Scholar 

  16. Purchase RJ, Wolf EM, Hobgood ER, Pollock ME, Smalley CC (2008) Hill-Sachs “remplissage”: an arthroscopic solution for the engaging Hill-Sachs lesion. Arthroscopy 24(6):723–726

    Article  PubMed  Google Scholar 

  17. Argintar E, Heckmann N, Wang L, Tibone JE, Lee TQ (2014) The biomechanical effect of shoulder remplissage combined with Bankart repair for the treatment of engaging Hill-Sachs lesions. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-014-3092-4

    PubMed  Google Scholar 

  18. Koo SS, Burkhart SS, Ochoa E (2009) Arthroscopic double-pulley remplissage technique for engaging Hill-Sachs lesions in anterior shoulder instability repairs. Arthroscopy 25(11):1343–1348

    Article  PubMed  Google Scholar 

  19. Longo UG, Loppini M, Rizzello G, Romeo G, Huijsmans PE, Denaro V (2014) Glenoid and humeral head bone loss in traumatic anterior glenohumeral instability: a systematic review. Knee Surg Sports Traumatol Arthrosc 22(2):392–414

    Article  PubMed  Google Scholar 

  20. Elkinson I, Giles JW, Faber KJ, Boons HW, Ferreira LM, Johnson JA et al (2012) The effect of the remplissage procedure on shoulder stability and range of motion: an in vitro biomechanical assessment. J Bone Joint Surg Am 94(11):1003–1012

    Article  PubMed  Google Scholar 

  21. Bhatia S, Frank RM, Ghodadra NS, Hsu AR, Romeo AA, Bach BR Jr et al (2014) The outcomes and surgical techniques of the Latarjet procedure. Arthroscopy 30(2):227–235

    Article  PubMed  Google Scholar 

  22. Doursounian L, Debet-Mejean A, Chetboun A, Nourissat G (2009) Bristow-Latarjet procedure with specific instrumentation: study of 34 cases. Int Orthop 33(4):1031–1036

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  23. Lafosse L, Boyle S (2010) Arthroscopic Latarjet procedure. J Shoulder Elbow Surg 19(2 Suppl):2–12

    Article  PubMed  Google Scholar 

  24. Longo UG, Loppini M, Rizzello G, Ciuffreda M, Maffulli N, Denaro V (2014) Latarjet, Bristow, and Eden-Hybinette procedures for anterior shoulder dislocation: systematic review and quantitative synthesis of the literature. Arthroscopy 30(9):1184–1211

    Article  PubMed  Google Scholar 

  25. Kraus TM, Graveleau N, Bohu Y, Pansard E, Klouche S, Hardy P (2013) Coracoid graft positioning in the Latarjet procedure. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-013-2651-4

    Google Scholar 

  26. Degen RM, Giles JW, Johnson JA, Athwal GS (2014) Remplissage versus Latarjet for engaging Hill-Sachs defects without substantial glenoid bone loss: a biomechanical comparison. Clin Orthop Relat Res 472(8):2363–2371

    Article  PubMed Central  PubMed  Google Scholar 

  27. De Beer J, Burkhart SS, Roberts CP, van Rooyen K, Cresswell T, du Toit DF (2009) The congruent-arc Latarjet. Tech Should Elbow Surg 10(2):62–67

    Article  Google Scholar 

  28. Brilakis E, Mataragas E, Deligeorgis A, Maniatis V, Antonogiannakis E (2014) Midterm outcomes of arthroscopic remplissage for the management of recurrent anterior shoulder instability. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-014-2848-1

    PubMed  Google Scholar 

  29. Flinkkila T, Hyvonen P, Ohtonen P, Leppilahti J (2010) Arthroscopic Bankart repair: results and risk factors of recurrence of instability. Knee Surg Sports Traumatol Arthrosc 18(12):1752–1758

    Article  PubMed  Google Scholar 

  30. Burkhart SS, Danaceau SM (2000) Articular arc length mismatch as a cause of failed Bankart repair. Arthroscopy 16(7):740–744

    Article  CAS  PubMed  Google Scholar 

  31. Longo UG, Loppini M, Rizzello G, Ciuffreda M, Berton A, Maffulli N et al (2014) Remplissage, humeral osteochondral grafts, weber osteotomy, and shoulder arthroplasty for the management of humeral bone defects in shoulder instability: systematic review and quantitative synthesis of the literature. Arthroscopy 30(12):1650–1666

    Article  PubMed  Google Scholar 

  32. Petrera M, Patella V, Patella S, Theodoropoulos J (2010) A meta-analysis of open versus arthroscopic Bankart repair using suture anchors. Knee Surg Sports Traumatol Arthrosc 18(12):1742–1747

    Article  CAS  PubMed  Google Scholar 

  33. Boileau P, O’Shea K, Vargas P, Pinedo M, Old J, Zumstein M (2012) Anatomical and functional results after arthroscopic Hill-Sachs remplissage. J Bone Joint Surg Am 94(7):618–626

    Article  PubMed  Google Scholar 

  34. Abdelhady A, AbouElsoud M (2014) Posterior capsular release and coracoid transfer for cases of neglected locked anterior shoulder dislocation in tramadol addicts. Eur Orthop Traumatol. doi:10.1007/s2570-014-0279-6

    Google Scholar 

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Compliance with ethical standards

This study has been conducted after approval of our ethical committee for research (and in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments).

Conflict of interest

The authors state that there has been no conflict of interest and there were no potential benefits in any form from a commercial party related directly or indirectly to the subject of this manuscript. No funds, grants, or personnel to be acknowledged have been hidden.

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Authors and Affiliations

  1. Ain Shams University, Cairo, Egypt

    Maged M. Abouelsoud & Amr A. Abdelrahman

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  1. Maged M. Abouelsoud
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  2. Amr A. Abdelrahman
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Correspondence to Maged M. Abouelsoud.

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Abouelsoud, M.M., Abdelrahman, A.A. Recurrent anterior shoulder dislocation with engaging Hill–Sachs defect: remplissage or Latarjet?. Eur Orthop Traumatol 6, 151–156 (2015). https://doi.org/10.1007/s12570-015-0313-3

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