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Return to Sport After Arthroscopic Bankart Repair With Remplissage: A Systematic Review

Published:January 12, 2023DOI:https://doi.org/10.1016/j.arthro.2022.12.032

      Purpose

      To determine the return-to-sport rate following arthroscopic Bankart repair with remplissage (ABR), including overall rate of return to sport, rate of return to preinjury level of sport, and the rate of return for specific subgroups such as contact or throwing athletes.

      Methods

      EMBASE, PubMed, and MEDLINE were searched from database inception until February 2022. Studies were screened by 2 reviewers independently and in duplicate for data regarding rates of return to sport following ABR. Data on return to sport and functional outcomes were recorded. Data are presented in a descriptive fashion.

      Results

      Overall, 20 studies were included with a total of 736 patients (738 shoulders) who underwent ABR. These patients had a mean age of 28 years (range 14-72 years) and were 83% male. Mean follow-up time after surgery was 45 months (range 12-127 months). The rate of return to any level of sport ranged from 60% to 100%, whereas the rate of return to the preinjury level ranged from 63% to 100%. When we excluded those who underwent ABR as a revision procedure, the rate of return to any level of sport was 68% to 100%. Lastly, the return to sport rates for contact or collision athletes ranged from 80% to 100%, whereas for overhead or throwing athletes it was 46% to 79%. The rate of recurrence of instability postoperatively ranged from 0% to 20% in included studies.

      Conclusions

      For athletes with anterior shoulder instability, ABR led to a high rate of return to sport along with a low rate of recurrence of instability. Although most athletes are able to return to the same level of sport, certain groups such as throwing athletes may face greater difficulty.

      Level of Evidence

      Level IV, systematic review of Level III and IV studies.
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      References

        • Cutts S.
        • Prempeh M.
        • Drew S.
        Anterior shoulder dislocation.
        Ann R Coll Surg Engl. 2009; 91: 2-7
        • Zacchilli M.A.
        • Owens B.D.
        Epidemiology of shoulder dislocations presenting to emergency departments in the United States.
        J Bone Joint Surg Am. 2010; 92: 542-549
        • Leroux T.
        • Wasserstein D.
        • Veillette C.
        • et al.
        Epidemiology of primary anterior shoulder dislocation requiring closed reduction in Ontario, Canada.
        Am J Sports Med. 2014; 42: 442-450
        • Vermeiren J.
        • Handelberg F.
        • Casteleyn P.P.
        • Opdecam P.
        The rate of recurrence of traumatic anterior dislocation of the shoulder—A study of 154 cases and a review of the literature.
        Int Orthop. 1993; 17: 337-341
        • Larrain M.V.
        • Botto G.J.
        • Montenegro H.J.
        • Mauas D.M.
        Arthroscopic repair of acute traumatic anterior shoulder dislocation in young athletes.
        Arthroscopy. 2001; 17: 373-377
        • Owens B.D.
        • Campbell S.E.
        • Cameron K.L.
        Risk factors for anterior glenohumeral instability.
        Am J Sports Med. 2014; 42: 2591-2596
        • Di Giacomo G.
        • Itoi E.
        • Burkhart S.S.
        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
        • Burkhart S.S.
        • De Beer J.F.
        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
        • Kim D.S.
        • Yoon Y.S.
        • Chang Ho Yi
        Prevalence comparison of accompanying lesions between primary and recurrent anterior dislocation in the shoulder.
        Am J Sports Med. 2010; 38: 2071-2076
        • Lau B.C.
        • Conway D.
        • Curran P.F.
        • Feeley B.T.
        • Pandya N.K.
        Bipolar bone loss in patients with anterior shoulder dislocation: A comparison of adolescents versus adult patients.
        Arthroscopy. 2017; 33: 1755-1761
        • Purchase R.J.
        • Wolf E.M.
        • Hobgood E.R.
        • Pollock M.E.
        • Smalley C.C.
        Hill-Sachs “remplissage”: An arthroscopic solution for the engaging Hill-Sachs lesion.
        Arthroscopy. 2008; 24: 723-726
        • Wagstrom E.
        • Raynor B.
        • Jani S.
        • et al.
        Epidemiology of glenohumeral instability related to sporting activities using the FEDS (Frequency, Etiology, Direction, and Severity) classification system: A multicenter analysis.
        Orthop J Sport Med. 2019; 7
        • Kasik C.S.
        • Rosen M.R.
        • Saper M.G.
        • Zondervan R.L.
        High rate of return to sport in adolescent athletes following anterior shoulder stabilisation: A systematic review.
        J ISAKOS. 2019; 4: 33-40
        • Memon M.
        • Kay J.
        • Cadet E.R.
        • Shahsavar S.
        • Simunovic N.
        • Ayeni O.R.
        Return to sport following arthroscopic Bankart repair: A systematic review.
        J Shoulder Elbow Surg. 2018; 27: 1342-1347
        • Abdul-Rassoul H.
        • Galvin J.W.
        • Curry E.J.
        • Simon J.
        • Li X.
        Return to Sport after surgical treatment for anterior shoulder instability: A systematic review.
        Am J Sports Med. 2019; 47: 1507-1515
        • Zhu Y.M.
        • Lu Y.
        • Zhang J.
        • Shen J.W.
        • Jiang C.Y.
        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. 2011; 39: 1640-1647
        • Han F.
        • Chin B.Y.Y.
        • Tan B.H.M.
        • Lim C.T.
        • Kumar V.P.
        Clinical outcomes of the reverse McLaughlin procedure for Hill–Sachs lesions in anterior shoulder instability.
        J Orthop Surg. 2019; 27: 1-7
        • McCabe M.P.
        • Weinberg D.
        • Field L.D.
        • O’Brien M.J.
        • Hobgood E.R.
        • Savoie F.H.
        Primary versus revision arthroscopic reconstruction with remplissage for shoulder instability with moderate bone loss.
        Arthroscopy. 2014; 30: 444-450
        • Garcia G.H.
        • Wu H.H.
        • Liu J.N.
        • Huffman G.R.
        • Kelly J.D.
        Outcomes of the remplissage procedure and its effects on return to sports.
        Am J Sports Med. 2016; 44: 1124-1130
        • Fakih R.
        • Hamie M.
        • Yassine M.
        Comparative study on the management of glenohumeral joint dislocation: Closed reduction vs. arthroscopic remplissage with Bankart lesion repair.
        J Med Liban. 2016; 64: 175-180
        • Higgins J.P.T.
        • Thomas J.
        • Chandler J.
        • et al.
        Cochrane handbook for systematic reviews of interventions.
        Ed 2. John Wiley and Sons, Chichester, UK2019
        • Moher D.
        • Shamseer L.
        • Clarke M.
        • et al.
        Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement.
        Syst Rev. 2015; 4: 1-9
        • Landis J.R.
        • Koch G.G.
        The measurement of observer agreement for categorical data.
        Biometrics. 1977; 33: 159
        • Slim K.
        • Nini E.
        • Forestier D.
        • Kwiatkowski F.
        • Panis Y.
        • Chipponi J.
        Methodological index for non-randomized studies (minors): Development and validation of a new instrument.
        ANZ J Surg. 2003; 73: 712-716
        • Shah A.
        • Kay J.
        • Memon M.
        • et al.
        What makes suture anchor use safe in hip arthroscopy? A systematic review of techniques and safety profile.
        Arthroscopy. 2019; 35: 1280-1293
        • Higgins J.P.T.
        • Thompson S.G.
        Quantifying heterogeneity in a meta-analysis.
        Stat Med. 2002; 21: 1539-1558
        • American Academy of Pediatrics Committee on Sports Medicine
        Recommendations for participation in competitive sports.
        Pediatrics. 1988; 81: 737-739
        • Bitar A.C.
        • Fabiani M.C.
        • Ferrari D.G.
        • et al.
        Clinical and functional outcomes of the remplissage technique to repair anterior shoulder dislocation: Average 7 years of follow-up.
        Musculoskelet Surg. 2021; 105: 61-67
        • Boileau P.
        • O’Shea K.
        • Vargas P.
        • Pinedo M.
        • Old J.
        • Zumstein M.
        Anatomical and functional results after arthroscopic Hill-Sachs remplissage.
        J Bone Joint Surg Am. 2012; 94: 618-626
        • Cavalier M.
        • Johnston T.R.
        • Tran L.
        • Gauci M.O.
        • Boileau P.
        Glenoid erosion is a risk factor for recurrent instability after Hill-Sachs remplissage.
        Bone Joint J. 2021; 103: 718-724
        • Garcia G.H.
        • Park M.J.
        • Zhang C.
        • Kelly J.D.
        • Huffman G.R.
        Large Hill-Sachs lesion: A comparative study of patients treated with arthroscopic Bankart repair with or without remplissage.
        HSS J. 2015; 11: 98-103
        • Hughes J.L.
        • Bastrom T.
        • Pennock A.T.
        • Edmonds E.W.
        Arthroscopic Bankart repairs with and without remplissage in recurrent adolescent anterior shoulder instability with Hill-Sachs deformity.
        Orthop J Sport Med. 2018; 6: 1-7
        • Sinha S.
        • Mehta N.
        • Goyal R.
        • Goyal A.
        • Joshi D.
        • Arya Rk
        Is revision Bankart repair with remplissage a viable option for failed Bankart repair in non-contact sports person aiming to return to sports?.
        Indian J Orthop. 2021; 55: 359-365
        • Bonnevialle N.
        • Azoulay V.
        • Faraud A.
        • Elia F.
        • Swider P.
        • Mansat P.
        Results of arthroscopic Bankart repair with Hill-Sachs remplissage for anterior shoulder instability.
        Int Orthop. 2017; 41: 2573-2580
        • Feng S.
        • Chen M.
        • Chen J.
        • Li H.
        • Chen J.
        • Chen S.
        Patient outcomes and fear of returning to sports after arthroscopic Bankart repair with remplissage.
        Orthop J Sport Med. 2021; 9: 1-7
        • Franceschi F.
        • Papalia R.
        • Rizzello G.
        • et al.
        Remplissage repair-new frontiers in the prevention of recurrent shoulder instability: A 2-year follow-up comparative study.
        Am J Sports Med. 2012; 40: 2462-2469
        • Lee Y.J.
        • Kim C.
        • Kim S.J.
        • Yoon T.H.
        • Cho J.Y.
        • Chun Y.M.
        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. 2021; 37: 450-456
        • Merolla G.
        • Paladini P.
        • di Napoli G.
        • Campi F.
        • Porcellini G.
        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. 2015; 43: 407-414
        • Domos P.
        • Ascione F.
        • Wallace A.L.
        Arthroscopic Bankart repair with remplissage for non-engaging Hill-Sachs lesion in professional collision athletes.
        Shoulder Elbow. 2019; 11: 17-25
        • Randelli P.S.
        • Compagnoni R.
        • Radaelli S.
        • Gallazzi M.B.
        • Tassi A.
        • Menon A.
        Arthroscopic remplissage is safe and effective: clinical and magnetic resonance results at a minimum 3 years of follow-up.
        J Orthop Traumatol. 2022; 23
        • Balg F.
        • Boileau P.
        The instability severity index score: A simple pre-operative score to select patients for arthroscopic or open shoulder stabilisation.
        J Bone Joint Surg Br. 2007; 89: 1470-1477
        • Yang J.S.
        • Mehran N.
        • Mazzocca A.D.
        • Pearl M.L.
        • Chen V.W.
        • Arciero R.A.
        Remplissage versus modified Latarjet for off-track Hill-Sachs lesions with subcritical glenoid bone loss.
        Am J Sports Med. 2018; 46: 1885-1891
        • Brilakis E.
        • Avramidis G.
        • Malahias M.A.
        • et al.
        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. 2019; 27: 305-313
        • Cho N.S.
        • Yoo J.H.
        • Juh H.S.
        • Rhee Y.G.
        Anterior shoulder instability with engaging Hill–Sachs defects: A comparison of arthroscopic Bankart repair with and without posterior capsulodesis.
        Knee Surg Sports Traumatol Arthrosc. 2016; 24: 3801-3808
        • Haviv B.
        • Mayo L.
        • Biggs D.
        Outcomes of arthroscopic “Remplissage”: Capsulotenodesis of the engaging large Hill-Sachs lesion.
        J Orthop Surg Res. 2011; 6: 29