Purpose
The purpose of this study was to compare functional outcome, return to sport, satisfaction,
postoperative recurrence, and complications in patients undergoing primary arthroscopic
Bankart repair with remplissage (ABR) to primary Latarjet.
Methods
A multicenter retrospective study was performed on patients undergoing primary ABR
or open Latarjet between 2013 and 2019 who had a minimum 2-year follow-up. Baseline
and two-year range of motion (ROM), patient-reported outcomes (PROs: Western Ontario
Shoulder Instability Index [WOSI], Single Assessment Numeric Evaluation [SANE], and
visual analog scale [VAS] for pain) recurrence, return to sport, satisfaction, and
complications were reviewed.
Results
This study included 258 patients, including 70 ABRs and 188 Latarjet procedures. Baseline
demographics, ROM, and PROs were similar. Mean preop glenoid bone loss (GBL) (12.3%
± 10.9% vs 7.6% ± 9%; P < .001) and off-track lesions (23% vs 13%; P = .046) were higher in the ABR group, while preoperative GBL range was similar (0-42%
vs 0-47%). Changes in the VAS (1.9 vs 0.9; P = .019) and WOSI (1096 vs 805; P < .001) were improved in ABR. The percentage of patients who achieved a minimal clinically
important difference was improved in WOSI for ABR and PASS for ABR in SANE, VAS, and
WOSI scores. The ABR cohort reported worse changes in external rotation (ER) (−4°
vs +19°; P < .001). Return to sport among overhead and contact athletes favored ABR (91.5% vs
72.7%; P = .007). Satisfaction and recurrent dislocation were similar. Surgical complications
were observed in 0% of ABR cases, compared to 5.9% in the Latarjet group.
Conclusion
Primary ABR resulted in 2-year functional outcomes that were as good or superior to
primary Latarjet, with higher return to sport for overhead and contact activities,
fewer complications, and comparably low recurrence rates, even despite greater bipolar
bone loss in the ABR cohort. However, this comes at the expense of decreased external
rotation, which may be considered in individual patients.
Level of Evidence
III, retrospective comparative study.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to ArthroscopyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Anterior shoulder instability: A review of pathoanatomy, diagnosis and treatment.Curr Rev Musculoskelet Med. 2011; 4: 200-207
- The epidemiology and natural history of anterior shoulder instability.Curr Rev Musculoskelet Med. 2017; 10: 411-424
- Diagnosis and management of traumatic anterior shoulder instability.J Am Acad Orthop Surg. 2021; 29: e51-e61
- The grooved defect of the humeral head: A frequently unrecognized complication of dislocations of the shoulder joint.Radiology. 1940; 35: 690-700
- 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. 2000; 16: 677-694
- Evolving concept of bipolar bone loss and the Hill-Sachs lesion: From "engaging/non-engaging" lesion to "on-track/off-track" lesion.Arthroscopy. 2014; 30: 90-98
- 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. 2007; 16: 649-656
- Arthroscopic remplissage for anterior shoulder instability: A systematic review of clinical and biomechanical studies.Arthroscopy. 2019; 35: 617-628
- Risk factors for the postoperative recurrence of instability after arthroscopic Bankart repair in athletes.Orthop J Sports Med. 2017; 5 (2325967117726494)
- Redefining "critical" bone loss in shoulder instability: Functional outcomes worsen with "subcritical" bone loss.Am J Sports Med. 2015; 43: 1719-1725
- Critical value of anterior glenoid bone loss that leads to recurrent glenohumeral instability after arthroscopic Bankart repair.Am J Sports Med. 2017; 45: 1975-1981
- Complications and re-operations after Bristow-Latarjet shoulder stabilization: A systematic review.J Shoulder Elbow Surg. 2013; 22: 286-292
- Arthroscopic Bankart-Bristow-Latarjet (2B3) procedure: How to do it and tricks to make it easier and safe.Orthop Clin N Am. 2010; 4: 381-392
- The congruent-arc Latarjet.Tech Shoulder Elbow Surg. 2009; 10: 62-67
- A propos du traitement des luxations r_ecidivantes de l’_epaule.Lyon Chir. 1954; 49: 994-1003
- The biomechanical effect of shoulder remplissage combined with Bankart repair for the treatment of engaging Hill-Sachs lesions.Knee Surg Sports Traumatol Arthrosc. 2016; 24: 585-592
- The effect of the remplissage procedure on shoulder stability and range of motion: an in vitro biomechanical assessment.J Bone Joint Surg Am. 2012; 94: 1003-1012
- 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. 2011; 39: 2147-2152
- The effect of the remplissage procedure on shoulder range of motion: A cadaveric study.Arthroscopy. 2014; 30: 178-187
- Recurrent anterior shoulder dislocation with engaging Hill-Sachs defect: Remplissage or Latarjet?.Eur Orthop Traumatol. 2015; 6: 151-156
- Chronic anterior shoulder instability with significant Hill-Sachs lesion: Arthroscopic Bankart with remplissage versus open Latarjet procedure.Orthop Traumatol Surg Res. 2018; 104: 17-22
- Management of an engaging Hill-Sachs lesion: Arthroscopic remplissage with Bankart repair versus Latarjet procedure.Knee Surg Sports Traumatol Arthrosc. 2016; 24: 3793-3800
- Remplissage versus Latarjet for engaging Hill-Sachs defects without substantial glenoid bone loss: A biomechanical comparison.Clin Orthop Relat Res. 2014; 472: 2363-2371
- Arthroscopic Bankart repair with Remplissage vs Latarjet procedure for management of engaging Hill-Sachs lesions with subcritical glenoid bone loss in traumatic anterior shoulder instability: A systemic review and meta-analysis.J Shoulder Elbow Surg. 2020; 29: 2163-2174
- Is arthroscopic Remplissage a tenodesis or capsulomyodesis? An anatomic study.Knee Surg Sports Traumatol Arthrosc. 2016; 24 (-577.24): 573
- Results of modified Latarjet reconstruction in patients with anteroinferior instability and significant boneloss.Arthroscopy. 2007; 23: 1033-1041
- Clinical validation of the glenoid track concept in anterior glenohumeral instability.J Bone Joint Surg Am. 2016; 98: 1918-1923
- 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. 2021; 30: 1288-1298
- Arthroscopic Bankart repair with remplissage for non-engaging Hill-Sachs lesion in professional collision athletes.Shoulder and Elbow. 2019; 11: 17-25
- Remplissage versus modified Latarjet for off-track Hill-Sachs lesions with subcritical glenoid bone loss.Am J Sports Med. 2018; 46: 1885-1891
- Does the clinically significant difference in visual analog scale pain scores vary with gender, age, or cause of pain?.Acad Emerg Med. 1998; 5: 1086-1090
- Return to sport after surgical treatment for anterior shoulder instability.Am J Sports Med. 2019; 6: 1507-1515
- Comparison of various imaging techniques to quantify glenoid bone loss in shoulder instability.J Shoulder Elbow Surg. 2013; 22: 528-534
- Arthroscopic versus open anterior shoulder stabilization: A prospective randomized clinical trial with 15-year follow-up with an assessment of the glenoid being “on-track” and “off-track” as a predictor of failure.Am J Sports Med. 2021; 49: 1999-2005
Article Info
Publication History
Published online: April 07, 2022
Accepted:
March 20,
2022
Received:
November 26,
2021
See commentary on page 2806Footnotes
The authors report the following potential conflicts of interest or sources of funding: P.N. reports personal fees from Arthrex , outside the submitted work. J.B. is a paid consultant for Arthrex , SBM, and Move-Up. He receives royalties from Move-Up. He is president of the Francophone Society of Arthroscopy. A.L. is a paid consultant for Arthrex, Stryker, and Medacta. He receives royalties from Stryker. He is president of the FORE Foundation and founder of BeeMed. P.J.D. reports grants from Arthrex, Inc., during the conduct of the study; personal fees and other from Arthrex , Inc., outside the submitted work. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Identification
Copyright
© 2022 by the Arthroscopy Association of North America
