BACKGROUND: Certain failures of arthroscopic Bankart repairs seem to be related to the presence of a Hill-Sachs defect. It has been suggested that Hill-Sachs lesions can be treated by "remplissage" (filling in) of the defect. The effect of this procedure on the mobility of the shoulder is not known. PURPOSE: To determine if filling in the Hill-Sachs defect with rotator cuff tendon would modify the range of motion of the operated shoulder. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: A prospective study of 2 patient populations (arthroscopic Bankart repair alone vs Bankart and remplissage) was undertaken after selecting patients using the Instability Severity Index Score (ISIS). Patients with a Hill-Sachs lesion seen on anteroposterior radiographs had a remplissage procedure if this procedure allowed them to obtain an ISIS lower than 4. The main clinical outcome was the range of motion (external rotation at the side [ER1], external rotation in abduction [ER2], internal rotation [IR], and forward elevation), assessed by the difference between each shoulder at 1 and 2 years' follow-up. Complications, recurrence, and the Walch-Duplay scores were noted at the same time. Minimum follow-up was 2 years. RESULTS: No significant statistical difference was noted in the range of motion between each group: ER1, difference of 4° (P = .22); ER2, difference of 3° (P = .49); anterior elevation, difference of 5° (P = .35); and internal rotation, 2 vertebrae (P = .22). The rate of recurrence was identical in both groups (6.25%). For patients without redislocation, the Walch-Duplay score was excellent (14/17) or good (3/17) in the first group and excellent (12/15) or good (3/15) in the second group. Posterosuperior pain during forceful movements or when tired was noted in one third of patients having undergone remplissage. CONCLUSION: The remplissage technique did not alter the range of motion of the shoulder compared with Bankart procedure alone; however, one third of patients did experience posterosuperior pain.
BACKGROUND: Certain failures of arthroscopic Bankart repairs seem to be related to the presence of a Hill-Sachs defect. It has been suggested that Hill-Sachs lesions can be treated by "remplissage" (filling in) of the defect. The effect of this procedure on the mobility of the shoulder is not known. PURPOSE: To determine if filling in the Hill-Sachs defect with rotator cuff tendon would modify the range of motion of the operated shoulder. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: A prospective study of 2 patient populations (arthroscopic Bankart repair alone vs Bankart and remplissage) was undertaken after selecting patients using the Instability Severity Index Score (ISIS). Patients with a Hill-Sachs lesion seen on anteroposterior radiographs had a remplissage procedure if this procedure allowed them to obtain an ISIS lower than 4. The main clinical outcome was the range of motion (external rotation at the side [ER1], external rotation in abduction [ER2], internal rotation [IR], and forward elevation), assessed by the difference between each shoulder at 1 and 2 years' follow-up. Complications, recurrence, and the Walch-Duplay scores were noted at the same time. Minimum follow-up was 2 years. RESULTS: No significant statistical difference was noted in the range of motion between each group: ER1, difference of 4° (P = .22); ER2, difference of 3° (P = .49); anterior elevation, difference of 5° (P = .35); and internal rotation, 2 vertebrae (P = .22). The rate of recurrence was identical in both groups (6.25%). For patients without redislocation, the Walch-Duplay score was excellent (14/17) or good (3/17) in the first group and excellent (12/15) or good (3/15) in the second group. Posterosuperior pain during forceful movements or when tired was noted in one third of patients having undergone remplissage. CONCLUSION: The remplissage technique did not alter the range of motion of the shoulder compared with Bankart procedure alone; however, one third of patients did experience posterosuperior pain.
Authors: Alexandre Lädermann; Paolo Arrigoni; Johannes Barth; Pablo Narbona; Bryan Hanypsiak; Stephen S Burkhart; Patrick J Denard Journal: Knee Surg Sports Traumatol Arthrosc Date: 2015-08-15 Impact factor: 4.342
Authors: Alexandra L Brooks-Hill; Bruce B Forster; Case van Wyngaarden; Robert Hawkins; William D Regan Journal: Clin Orthop Relat Res Date: 2013-05-08 Impact factor: 4.176
Authors: Miguel Angel Ruiz Ibán; Cristina Victoria Asenjo Gismero; Santos Moros Marco; Raquel Ruiz Díaz; Teresa Del Olmo Hernández; Gabriel Del Monte Bello; Miguel García Navlet; Jose Luis Ávila Lafuente; Jorge Díaz Heredia Journal: Knee Surg Sports Traumatol Arthrosc Date: 2019-04-06 Impact factor: 4.342