Abstract
Purpose
The purpose of the study was to present midterm results concerning the management of recurrent anterior shoulder instability with the remplissage technique in addition to the classic Bankart repair, in patients with engaging Hill–Sachs lesions.
Methods
During a time period of 4 years (January 2007–December 2010), 48 patients with an average age of 28.9 ± 7.8 years were operated on in our department. They all had a positive apprehension sign pre-operatively and satisfied the inclusion criteria of this study. Seventy-nine per cent of these patients were involved in sport activities of different levels. The mean follow-up period was 37.2 ± 9.9 months.
Results
Three patients (6.3 %) had suffered a new dislocation: one of them after a low-energy trauma and the two other after a high-energy trauma. The rest of the patients (93.7 %) were satisfied with the surgical result and returned to their previous everyday activities while 70.8 % continued to participate in sporting activities without restrictions. The ASES score increased from 67.7 ± 21.5 points pre-operatively to 90.8 ± 21.7 points post-operatively (p < 0.01), the modified Rowe score from 38 ± 17.3 to 93.8 ± 14.5 (p < 0.001) and the Oxford Instability score from 27.6 ± 11.1 to 45.1 ± 8.3 (p < 0.001). No significant restriction in shoulder range of motion was documented.
Conclusions
The outcome of the enhancement of the classic Bankart repair with tenodesis of the infraspinatus and posterior capsular plication is very good as far as the management of recurrent anterior shoulder instability is concerned, without significantly influencing the range of motion of the shoulder.
Level of evidence
Therapeutic study—case series with no comparison group, Level IV.
Similar content being viewed by others
References
Boileau P, Villalba M, Hery 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
Burkhart S, De Beer J (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
Burkhart SS, De Beer JF, Tehrany AM, Parten PM (2002) Quantifying glenoid bone loss arthroscopically in shoulder instability. Arthroscopy 18(5):488–491
Burkhart SS, Danaceau SM (2000) Articular arc length mismatch as a cause of failed Bankart repair. Arthroscopy 16(7):740–744
Calandra JJ, Baker CL, Uribe J (1989) The incidence of Hill–Sachs lesions in initial anterior shoulder dislocations. Arthroscopy 5(4):254–257
Carreira DS, Mazzocca AD, Oryhon J, Brown FM, Hayden JK, Romeo AA (2006) A prospective outcome evaluation of arthroscopic Bankart repairs: minimum 2-year follow-up. Am J Sports Med 34(5):771–777
Connolly JF (1972) Humeral head defects associated with shoulder dislocations. Their diagnostic and surgical significance. In: Instructional Course Lectures. The American Academy of Orthopaedic Surgeons Volume 21. Mosby, St.Louis, p 42–54
Deutsch AA, Kroll DG (2008) Decreased range of motion following arthroscopic remplissage. Orthopedics 31:492
Engebretsen L, Craig EV (1993) Radiologic features of shoulder instability. Clin Ortllop Relat Res 291:29–44
Franceschi F, Longo U, Ruzzini L, Rizzello G, Maffulli N, Denaro V (2008) Arthroscopic salvage of failed arthroscopic Bankart repair: a prospective study with a minimum follow-up of 4 years. Am J Sports 36(7):1330–1336
Garth WP Jr, Slappey CE, Ochs CW (1984) Roentgenographic demonstration of instability of the shoulder: the apical oblique projection. A technical note. J Bone Joint Surg Am 66:1450–1453
Gartsman GM, Roddey TS, Hammerman SM (2000) Arthroscopic treatment of anterior-inferior glenohumeral instability: 2–5-year follow up. J Bone Joint Surg Am 82(7):991–1003
Hayashida K, Yoneda M, Mizuno N, Fukushima S, Nakagawa S (2006) Arthroscopic Bankart repair with knotless suture anchor for traumatic anterior shoulder instability: results of short-term follow-up. Arthroscopy 22(6):620–626
Ide J, Maeda S, Takagi K (2004) Arthroscopic Bankart repair using suture anchors in athletes: patient selection and postoperative sports activity. Am J Sports Med 32(8):1899–1905
Kim SH, Ha KI, Cho YB, Ryu BD, Oh I (2003) Arthroscopic anterior stabilization of the shoulder: 2–6-year follow-up. J Bone Joint Surg Am 85(8):1511–1518
Marquardt B, Witt KA, Liem D, Steinbeck J, Potzl W (2006) Arthroscopic Bankart repair in traumatic anterior shoulder instability using a suture anchor technique. Arthroscopy 22(9):931–936
Mologne TS, Provencher MT, Menzel KA, Vachon TA, Dewing CB (2007) Arthroscopic stabilization in patients with an inverted pear glenoid: results in patients with bone loss of the anterior glenoid. Am J Sports Med 35(8):1276–1283
Namdari S, Yagnik G, Ebaugh DD, Nagda S, Ramsey ML, Williams GR Jr, Mehta S (2012) Defining functional shoulder range of motion for activities of daily living. J Shoulder Elbow Surg 21(9):1177–1183
Oh JH, Lee HK, Kim JY, Kim SH, Gong HS (2009) Clinical and radiologic outcomes of arthroscopic glenoid labrum repair with the bioknotless suture anchor. Am J Sports Med 37(12):2340–2348
Ozbaydar M, Elhassan B, Diller D, Massimini D, Higgins LD, Warner JJ (2008) Results of arthroscopic capsulolabral repair: Bankart lesion versus anterior labroligamentous periosteal sleeve avulsion lesion. Arthroscopy 24(11):1277–1283
Papalia R, Osti L, Del Buono A, Denaro V, Maffulli N (2010) Glenohumeral arthropathy following stabilization for recurrent instability. Br Med Bull 96:75–92
Porcellini G, Campi F, Pegreffi F, Castagna A, Paladini P (2009) Predisposing factors for recurrent shoulder dislocation after arthroscopic treatment. J Bone Joint Surg Am 91(11):2537–2542
Provencher MT, Rose M, Peace W (2011) Hill–Sachs injuries of the shoulder. When are these important and how should I manage them? In: Abrams JS (ed) Management of the unstable shoulder: arthroscopic and open repair. SLACK, United States, pp 235–252
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
Rafert JA, Long BW, Hernandez EM, Kreipke DL (1990) Axillary shoulder with exaggerated rotation: the Hill–Sachs defect. Radiol Technol 62(1):18–21
Richards RD, Sartoris DJ, Pathria MN, Resnick D (1994) Hill–Sachs lesion and normal humeral groove: MR imaging features allowing their differentiation. Radiology 190(3):665–668
Rowe CR, Zarins B, Ciullo JV (1984) Recurrent anterior dislocation of the shoulder after surgical repair: apparent causes of failure and treatment. J Bone Joint Surg Am 66:159–168
Spatschil A, Landsiedl F, Anderl W, Imhoff A, Seiler H, Vassilev I, Klein W, Boszotta H, Hoffmann F, Rupp S (2006) Posttraumatic anterior-inferior instability of the shoulder: arthroscopic findings and clinical correlations. Arch Orthop Trauma Surg 126(4):217–222
Sugaya H, Moriishi J, Kanisawa I, Tsuchiya A (2005) Arthroscopic osseous Bankart repair for chronic recurrent traumatic anterior glenohumeral instability. J Bone Joint Surg Am 87(8):1752–1760
Voos JE, Livermore RW, Feeley BT, Altchek DW, Williams RJ, Warren RF, Cordasco FA, Allen AA (2010) Prospective evaluation of arthroscopic Bankart repairs for anterior instability. Am J Sports Med 38(2):302–307
Wheeless CR (2012) Anterior instability of the shoulder. In: Wheeless’ textbook of orthopaedics. Available http://www.wheelessonline.com/ortho/anterior_instability_of_the_shoulder
Wolf E, Pollack M (2004) Hill–Sachs ‘‘remplissage’’: an arthroscopic solution for the engaging Hill–Sachs lesion. Arthroscopy 20(Supplement 1):e14–e15
Yiannakopoulos C, Mataragas E, Antonogiannakis E (2007) A comparison of the spectrum of intra-articular lesions in acute and chronic anterior shoulder instability. Arthroscopy 23(9):985–990
Zhu YM, Lu Y, Zhang J, Shen JW, Jiang CY (2011) Arthroscopic Bankart repair combined with remplissage technique for the treatment of anterior shoulder instability with engaging Hill–Sachs lesion: a report of 49 cases with a minimum 2-year follow-up. Am J Sports Med 39:1640–1647
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Brilakis, E., Mataragas, E., Deligeorgis, A. et al. Midterm outcomes of arthroscopic remplissage for the management of recurrent anterior shoulder instability. Knee Surg Sports Traumatol Arthrosc 24, 593–600 (2016). https://doi.org/10.1007/s00167-014-2848-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00167-014-2848-1