Skip to main content

Advertisement

SpringerLink
Log in

Rotator interval closure has no additional effect on shoulder stability compared to Bankart repair alone

  • Arthroscopy and Sports Medicine
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Purpose

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.

Methods

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.

Results

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].

Conclusions

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

Level 2.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Kim SH, Ha KI, Kim SH (2002) Bankart repair in traumatic anterior shoulder instability: open versus arthroscopic technique. Arthroscopy 18(7):755–763

    Article  PubMed  Google Scholar 

  2. Shibata H, Gotoh M, Mitsui Y, Kai Y, Nakamura H, Kanazawa T, Okawa T, Higuchi F, Shirahama M, Shiba N (2014) Risk factors for shoulder re-dislocation after arthroscopic Bankart repair. J Orthop Surg Res 9:53. doi:10.1186/s13018-014-0053-z

    Article  PubMed  PubMed Central  Google Scholar 

  3. Voos JE, Livermore RW, Feeley BT, Altchek DW, Williams RJ, Warren RF, Cordasco FA, Allen AA; Service HSSSM (2010) Prospective evaluation of arthroscopic bankart repairs for anterior instability. Am J Sports Med 38(2):302–307. doi:10.1177/0363546509348049

    Article  PubMed  Google Scholar 

  4. 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. doi:10.2106/JBJS.E.00817

    PubMed  Google Scholar 

  5. 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 

  6. Hunt SA, Kwon YW, Zuckerman JD (2007) The rotator interval: anatomy, pathology, and strategies for treatment. J Am Acad Orthop Surg 15(4):218–227

    Article  PubMed  Google Scholar 

  7. Stokes DA, Savoie FH 3rd, Field LD, Ramsey JR (2003) Arthroscopic repair of anterior glenohumeral instability and rotator interval lesions. Orthop Clin N Am 34(4):529–538

    Article  Google Scholar 

  8. 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. doi:10.1016/j.arthro.2008.03.015

    Article  PubMed  Google Scholar 

  9. Wolf EM, Arianjam A (2014) Hill–Sachs remplissage, an arthroscopic solution for the engaging Hill–Sachs lesion: 2- to 10-year follow-up and incidence of recurrence. J Shoulder Elbow Surg 23(6):814–820. doi:10.1016/j.jse.2013.09.009

    Article  PubMed  Google Scholar 

  10. Chechik O, Maman E, Dolkart O, Khashan M, Shabtai L, Mozes G (2010) Arthroscopic rotator interval closure in shoulder instability repair: a retrospective study. J Shoulder Elbow Surg 19(7):1056–1062. doi:10.1016/j.jse.2010.03.001

    Article  PubMed  Google Scholar 

  11. Wynne-Davies R, Gormley J (1981) Clinical and genetic patterns in osteogenesis imperfecta. Clin Orthop Relat Res 159:26–35

    Google Scholar 

  12. Rouleau DM, Faber K, MacDermid JC (2010) Systematic review of patient-administered shoulder functional scores on instability. J Shoulder Elbow Surg 19(8):1121–1128. doi:10.1016/j.jse.2010.07.003

    Article  PubMed  Google Scholar 

  13. Gerber C, Nyffeler RW (2002) Classification of glenohumeral joint instability. Clin Orthop Relat Res (400):65–76

  14. Hewitt M, Getelman MH, Snyder SJ (2003) Arthroscopic management of multidirectional instability: pancapsular plication. Orthop Clin N Am 34(4):549–557

    Article  Google Scholar 

  15. Shafer BL, Mihata T, McGarry MH, Tibone JE, Lee TQ (2008) Effects of capsular plication and rotator interval closure in simulated multidirectional shoulder instability. J Bone Joint Surg Am 90(1):136–144. doi:10.2106/JBJS.F.00841

    Article  PubMed  Google 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

    Article  PubMed  Google Scholar 

  17. Cho NS, Yoo JH, Rhee YG (2015) Management of an engaging Hill–Sachs lesion: arthroscopic remplissage with Bankart repair versus Latarjet procedure. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-015-3666-9

    Google Scholar 

  18. Ladermann A, Arrigoni P, Barth J, Narbona P, Hanypsiak B, Burkhart SS, Denard PJ (2015) Is arthroscopic remplissage a tenodesis or capsulomyodesis? An anatomic study. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-015-3756-8

    Google 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

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

Esther Eshkol is thanked for editorial assistance.

Author information

Authors and Affiliations

  1. Shoulder Unit, Division of Orthopaedic Surgery, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, 6 Weizman Street, Tel Aviv, 64239, Israel

    Eran Maman, Oleg Dolkart, Efi Kazum, Noam Rosen, Gavriel Mozes, Michael Drexler & Ofir Chechik

Authors
  1. Eran Maman
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Oleg Dolkart
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Efi Kazum
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Noam Rosen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Gavriel Mozes
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Michael Drexler
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Ofir Chechik
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Oleg Dolkart.

Ethics declarations

Conflict of interest

None.

IRB approval

The study was approved by the Tel Aviv Sourasky Medical Center Ethical Committee: Study number: TLV-0256-09.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Maman, E., Dolkart, O., Kazum, E. et al. Rotator interval closure has no additional effect on shoulder stability compared to Bankart repair alone. Arch Orthop Trauma Surg 137, 673–677 (2017). https://doi.org/10.1007/s00402-017-2665-3

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00402-017-2665-3

Keywords

Search

Navigation