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Long-term outcomes of arthroscopic Bankart repair and Hill-Sachs remplissage for bipolar bone defects

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate long-term results after arthroscopic Bankart repair and Hill-Sachs remplissage (BHSR) in bipolar bone defects with less than 20% of glenoid bone loss (GBL) and to analyse risk factors for recurrent dislocation.

Methods

From 2009–2012, 43 patients with recurrent anterior shoulder instability were treated with BHSR. Inclusion criteria were GBL < 20% and minimum of 4-yearfollow-up. There were 35 males and 8 females with a mean age of 29 years (range 16–53). The mean ISIS score was 3.6 (range 2–6). Patients were evaluated for recurrence, range of motion and functional outcomes (Walch–Duplay and Rowe score). Post-operative MRI was performed at least 6 months after surgery to evaluate infraspinatus capsulotenodesis healing. Glenoid track was assessed retrospectively from pre-operative computed tomography. Mean follow-up was 7.3 years (range 4–11).

Results

At the last follow-up, good to excellent outcomes were reported in 86% of patients. Average post-operative Walch–Duplay was 87.9 (range 75–100) and ROWE 93.7 (range 70–100). Infraspinatus capsulotenodesis healing was achieved in 86%. The rate of recurrence and revision surgery was 9.3% and 13.9%, respectively. Recurrence was associated with higher ISIS score (p = 0.0191) and lower age at surgery (p = 0.0227). Four (9.3%) Hill-Sachs lesions were considered off-track. The presence of off-track Hill-Sachs was associated with higher risk of recurrence (p < 0.00001).

Conclusion

Arthroscopic BHSR improves shoulder instability in the setting of bipolar bone defects with less than 20% of GBL. Patient-related factors and pre-operative glenoid track should be taken into consideration to reduce the risk of recurrence.

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References

  1. Burkhart SS, Danaceau SM (2000) Articular arc length mismatch as a cause of failed bankart repair. Arthroscopy 16(7):740–744. https://doi.org/10.1053/jars.2000.7794

    Article  CAS  PubMed  Google Scholar 

  2. Di Giacomo G, Itoi E, Burkhart SS (2014) Evolving concept of bipolar bone loss and the Hill-Sachs lesion: from “engaging/non-engaging” lesion to “on-track/off-track” lesion. Arthroscopy 30(1):90–98. https://doi.org/10.1016/j.arthro.2013.10.004

    Article  PubMed  Google Scholar 

  3. Garcia GH, Park MJ, Zhang C, Kelly JD 4th, Huffman GR (2015) Large Hill-Sachs Lesion: a comparative study of patients treated with arthroscopic Bankart repair with or without remplissage. HSS J 11(2):98–103. https://doi.org/10.1007/s11420-015-9438-8

    Article  PubMed  PubMed Central  Google Scholar 

  4. Yamamoto N, Itoi E, Abe H, Kikuchi K, Seki N, Minagawa H, Tuoheti Y (2009) Effect of an anterior glenoid defect on anterior shoulder stability: a cadaveric study. Am J Sports Med 37(5):949–954. https://doi.org/10.1177/0363546508330139

    Article  PubMed  Google Scholar 

  5. Yamamoto N, Itoi E, Abe H, Minagawa H, Seki N, Shimada Y, Okada K (2007) Contact between the glenoid and the humeral head in abduction, external rotation, and horizontal extension: a new concept of glenoid track. J Shoulder Elbow Surg 16(5):649–656. https://doi.org/10.1016/j.jse.2006.12.012

    Article  PubMed  Google Scholar 

  6. Itoi E (2017) “On-track” and “off-track” shoulder lesions. EFORT Open Rev 2(8):343–351. https://doi.org/10.1302/2058-5241.2.170007

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. 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. https://doi.org/10.1016/j.arthro.2008.03.015

    Article  PubMed  Google Scholar 

  8. 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. https://doi.org/10.2106/JBJS.K.00101

    Article  PubMed  Google Scholar 

  9. Park I, Kang JS, Jo YG, Kim SW, Shin SJ (2019) Off-track Hill-Sachs lesions do not increase postoperative recurrent instability after arthroscopic Bankart repair with selective Remplissage procedure. Knee Surg Sports Traumatol Arthrosc 27(12):3864–3870. https://doi.org/10.1007/s00167-019-05441-2

    Article  PubMed  Google Scholar 

  10. Brilakis E, Avramidis G, Malahias MA, Stathellis A, Deligeorgis A, Chiotis I, Mataragas E, Chronopoulos E, Antonogiannakis E (2019) Long-term outcome of arthroscopic remplissage in addition to the classic Bankart repair for the management of recurrent anterior shoulder instability with engaging Hill-Sachs lesions. Knee Surg Sports Traumatol Arthrosc 27(1):305–313. https://doi.org/10.1007/s00167-018-5261-3

    Article  PubMed  Google Scholar 

  11. Cho NS, Yoo JH, Juh HS, Rhee YG (2016) Anterior shoulder instability with engaging Hill-Sachs defects: a comparison of arthroscopic Bankart repair with and without posterior capsulodesis. Knee Surg Sports Traumatol Arthrosc 24(12):3801–3808. https://doi.org/10.1007/s00167-015-3686-5

    Article  PubMed  Google Scholar 

  12. Bonnevialle N, Azoulay V, Faraud A, Elia F, Swider P, Mansat P (2017) Results of arthroscopic Bankart repair with Hill-Sachs remplissage for anterior shoulder instability. Int Orthop 41(12):2573–2580. https://doi.org/10.1007/s00264-017-3491-5

    Article  PubMed  Google Scholar 

  13. 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. https://doi.org/10.1177/0363546514559706

    Article  PubMed  Google Scholar 

  14. Lee YJ, Kim C, Kim SJ, Yoon TH, Cho JY, Chun YM (2021) Does an “Off-Track” Hill-Sachs lesion that is misclassified as “non-engaging” affect outcomes from bankart repair alone compared with Bankart repair combined with remplissage? Arthroscopy 37(2):450–456. https://doi.org/10.1016/j.arthro.2020.09.037

    Article  PubMed  Google Scholar 

  15. MacDonald P, McRae S, Old J, Marsh J, Dubberley J, Stranges G, Koenig J, Leiter J, Mascarenhas R, Prabhakar S, Sasyniuk T, Lapner P (2021) Arthroscopic Bankart repair with and without arthroscopic infraspinatus remplissage in anterior shoulder instability with a Hill-Sachs defect: a randomized controlled trial. J Shoulder Elbow Surg 30(6):1288–1298. https://doi.org/10.1016/j.jse.2020.11.013

    Article  PubMed  Google Scholar 

  16. Yang JS, Mehran N, Mazzocca AD, Pearl ML, Chen VW, Arciero RA (2018) Remplissage versus modified latarjet for off-track Hill-Sachs lesions with subcritical glenoid bone loss. Am J Sports Med 46(8):1885–1891. https://doi.org/10.1177/0363546518767850

    Article  PubMed  Google Scholar 

  17. Hatta T, Yamamoto N, Shinagawa K, Kawakami J, Itoi E (2019) Surgical decision making based on the on-track/off-track concept for anterior shoulder instability: a case-control study. JSES open access 3(1):25–28. https://doi.org/10.1016/j.jses.2018.10.001

    Article  PubMed  PubMed Central  Google Scholar 

  18. Boileau P, McClelland WB Jr, O’Shea K, Vargas P, Pinedo M, Old J, Zumstein MA (2014) Arthroscopic Hill-Sachs remplissage with bankart repair: strategy and technique. JBJS Essent Surg Tech 4(1):e4. https://doi.org/10.2106/JBJS.ST.M.00033

    Article  PubMed  PubMed Central  Google Scholar 

  19. Bishop JY, Hidden KA, Jones GL, Hettrich CM, Wolf BR, & MOON Shoulder Group (2019) Factors influencing surgeon's choice of procedure for anterior shoulder instability: a multicenter prospective cohort study. Arthroscopy 35(7):2014–2025. https://doi.org/10.1016/j.arthro.2019.02.035

  20. Nourissat G, Kilinc AS, Werther JR, Doursounian L (2011) A prospective, comparative, radiological, and clinical study of the influence of the “remplissage” procedure on shoulder range of motion after stabilization by arthroscopic Bankart repair. Am J Sports Med 39(10):2147–2152. https://doi.org/10.1177/0363546511416315

    Article  PubMed  Google Scholar 

  21. Walch G, Boileau P, Levigne C, Mandrino A, Neyret P, Donell S (1995) Arthroscopic stabilization for recurrent anterior shoulder dislocation: results of 59 cases. Arthroscopy 11(2):173–179. https://doi.org/10.1016/0749-8063(95)90063-2

    Article  CAS  PubMed  Google Scholar 

  22. Boileau P, Villalba M, Héry JY, Balg F, Ahrens P, Neyton L (2006) Risk factors for recurrence of shoulder instability after arthroscopic Bankart repair. J Bone Joint Surg Am 88(8):1755–1763. https://doi.org/10.2106/JBJS.E.00817

    Article  PubMed  Google Scholar 

  23. Liu JN, Gowd AK, Garcia GH, Cvetanovich GL, Cabarcas BC, Verma NN (2018) Recurrence rate of instability after remplissage for treatment of traumatic anterior shoulder instability: a systematic review in treatment of subcritical glenoid bone loss. Arthroscopy 34(10):2894-2907.e2. https://doi.org/10.1016/j.arthro.2018.05.031

    Article  PubMed  Google Scholar 

  24. Bastard C, Herisson O, Gaillard J, Nourissat G (2019) Impact of remplissage on global shoulder outcome: a long-term comparative study. Arthroscopy 35(5):1362–1367. https://doi.org/10.1016/j.arthro.2019.01.013

    Article  PubMed  Google Scholar 

  25. Ahmed I, Ashton F, Robinson CM (2012) Arthroscopic Bankart repair and capsular shift for recurrent anterior shoulder instability: functional outcomes and identification of risk factors for recurrence. J Bone Joint Surg Am 94(14):1308–1315. https://doi.org/10.2106/JBJS.J.01983

    Article  PubMed  Google Scholar 

  26. Phadnis J, Arnold C, Elmorsy A, Flannery M (2015) Utility of the instability severity index score in predicting failure after arthroscopic anterior stabilization of the shoulder. Am J Sports Med 43(8):1983–1988. https://doi.org/10.1177/0363546515587083

    Article  PubMed  Google Scholar 

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Acknowledgements

The authors would like to thank I. Nid Tahar for her assistance with editing the manuscript.

Funding

None.

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Authors and Affiliations

  1. Paris Shoulder Unit, Institut de La Main Clinique Bizet, 21 bis rue Georges Bizet, 75116, Paris, France

    Natalia Martinez-Catalan & Philippe Valenti

  2. Hospital Fundación Jiménez Diaz, Avenida de los Reyes Católicos 2, 28040, Madrid, Spain

    Natalia Martinez-Catalan

  3. Division of Orthopaedic Surgery, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Efi Kazum

  4. Hand-Upper Limb-Microsurgery Department, General Hospital KAT, Athens, Greece

    Frantzeska Zampeli PhD

  5. Shoulder Surgery, Hospital del Trabajador de Santiago, Ramón Carnicer 185, Providencia, Región Metropolitana, Chile

    Marco Cartaya

  6. CMCO Centre Méditerranéen De Chirurgie Orthopédique, 189 ter Av. François Mitterrand, 13170, Les Pennes-Mirabeau, France

    Alexandre Cerlier

Authors
  1. Natalia Martinez-Catalan
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  2. Efi Kazum
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  4. Marco Cartaya
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Correspondence to Natalia Martinez-Catalan.

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The authors report no conflicts of interest or sources of funding.

Ethical approval

This study was classified as observational (non-interventional) by our local ethics committee Statutory and ethical obligations of observational (non-interventional) studies in France: According to the past Huriet law on biomedical research, and to the current regulation that went into effect in august 2006 (law no. 2004–806), such studies do not require prior submission or approval to/from an IRB, and they do not require written consent. There is a current discrepancy on observational studies between the French legal requirements and the editors’ requirements. This observational research on data fulfils current French regulatory and ethical obligations.

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Martinez-Catalan, N., Kazum, E., Zampeli, F. et al. Long-term outcomes of arthroscopic Bankart repair and Hill-Sachs remplissage for bipolar bone defects. Eur J Orthop Surg Traumatol 33, 947–953 (2023). https://doi.org/10.1007/s00590-022-03237-8

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  • DOI: https://doi.org/10.1007/s00590-022-03237-8

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