Rotator interval closure has no additional effect on shoulder stability compared to Bankart repair alone
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Arthroscopic Bankart repair (ABR) provides satisfactory results for recurrent anterior shoulder instability, but the high recurrence rate post-ABR remain a concern. One of the adjunct procedures proposed to improve ABR results is arthroscopic rotator interval closure (ARIC). This study prospectively evaluated the outcomes of ABRs alone compared to combined ABR + ARIC and identified risk factors related to failure of each procedure.
Thirty-nine consecutive patients (mean age 23.1 (18.3–37.5) years; 37 males) underwent arthroscopic stabilization for recurrent anterior traumatic shoulder instability. Twenty patients underwent ABR alone and 19 underwent ABR + ARIC. Remplissage was added when glenoid engagement was observed during surgery. All patients were prospectively followed, and their postoperative courses were reviewed and functionally assessed at the last visit.
The re-dislocation rate was higher in the ABR + ARIC group compared to the ABR only group at a mean follow-up of 4.2 (2–5.6) years (3 vs. 0, P = 0.06). More subluxations were found in the ABR only group (2 vs. 1, respectively; P = 0.58). The final limitation of range of motion (ROM) compared with the preoperative ROM was similar in both groups. Remplissage procedures were performed more often in the ABR only group [12 (60%) vs. 4 (21%), P = 0.013].
ARIC performed as an adjunct to ABR showed no superiority in attaining value-added stability compared to ABR alone. Adding a remplissage procedure may achieve better stability.
Level of evidence
KeywordsShoulder dislocation Bankart repair Arthroscopy Rotator interval Hyperlaxity Remplissage
Esther Eshkol is thanked for editorial assistance.
Compliance with ethical standards
Conflict of interest
The study was approved by the Tel Aviv Sourasky Medical Center Ethical Committee: Study number: TLV-0256-09.
- 11.Wynne-Davies R, Gormley J (1981) Clinical and genetic patterns in osteogenesis imperfecta. Clin Orthop Relat Res 159:26–35Google Scholar
- 13.Gerber C, Nyffeler RW (2002) Classification of glenohumeral joint instability. Clin Orthop Relat Res (400):65–76Google Scholar
- 16.Mologne TS, Zhao K, Hongo M, Romeo AA, An KN, Provencher MT (2008) The addition of rotator interval closure after arthroscopic repair of either anterior or posterior shoulder instability: effect on glenohumeral translation and range of motion. Am J Sports Med 36(6):1123–1131. doi: 10.1177/0363546508314391 CrossRefPubMedGoogle Scholar
- 19.Merolla G, Paladini P, Di Napoli G, Campi F, Porcellini G (2015) Outcomes of arthroscopic Hill–Sachs remplissage and anterior Bankart repair: a retrospective controlled study including ultrasound evaluation of posterior capsulotenodesis and infraspinatus strength assessment. Am J Sports Med 43(2):407–414. doi: 10.1177/0363546514559706 CrossRefPubMedGoogle Scholar