Purpose
To determine whether arthroscopic remplissage with Bankart repair is an effective
treatment strategy for patients with Bankart lesions and large Hill-Sachs defects.
Methods
Between 2006 and 2008, 20 patients underwent arthroscopic Bankart repair with remplissage
for the treatment of recurrent anterior glenohumeral instability and large Hill-Sachs
defects. Preoperative imaging in all patients identified avulsion of the anterior
inferior glenohumeral ligament with an associated Hill-Sachs defect that involved
greater than 25% of the humeral head. Patients were followed up postoperatively with
the Western Ontario Shoulder Instability score, the American Shoulder and Elbow Surgeons
score, and the Penn Shoulder Score. Recurrent subluxation or dislocation was documented.
Results
There were 15 male patients and 5 female patients. The mean age of the patients was
27.3 years. The mean length of follow-up in this series was 29.2 months (range, 24.3
to 37.7 months). At final follow-up, 3 patients reported recurrence of instability,
which spontaneously reduced in all cases. The mean American Shoulder and Elbow Surgeons
score was 92.5 (pain, 47.3; function, 45.3). The mean Penn score was 90 of 100 (pain,
27.3 of 30; satisfaction, 8.5 of 10; function, 54.3 of 60). The mean total Western
Ontario Shoulder Instability score was 72.74% (mean physical symptom score, 77.10%;
mean sports and recreation score, 70.25%; mean lifestyle score, 75%; mean emotions
score, 58.50%).
Conclusions
Using an all-arthroscopic remplissage technique with Bankart repair, we were able
to restore function, diminish pain, and yield satisfaction in 85% of the patients
in this study. Our results compare favorably with historic controls with similar pathology
at early- to intermediate-term follow-up in terms of recurrence.
Level of Evidence
Level IV, therapeutic case series.
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Article Info
Publication History
Published online: August 08, 2011
Accepted:
May 12,
2011
Received:
July 22,
2010
Footnotes
Research was performed at the University of Pennsylvania and Temple University. The authors report no conflict of interest.
Note: To access the video accompanying this report, visit the September issue of Arthroscopy at www.arthroscopyjournal.org.
Identification
Copyright
© 2011 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
