Peter Domos1, Francesco Ascione2, Andrew L Wallace3. 1. Department of Trauma and Orthopaedics, Northern General Hospital, Sheffield, UK. 2. Department of Orthopedics, Seconda Università degli Studi di Napoli, Naples, Italy. 3. Shoulder Unit, Hospital of St John and St Elizabeth and Fortius Clinic, London, UK.
Abstract
BACKGROUND: The present study aimed to determine whether arthroscopic remplissage with Bankart repair is an effective treatment for improving outcomes for collision athletes with Bankart and non-engaging Hill-Sachs lesions. METHODS: Twenty collision athletes underwent arthroscopic Bankart repair with posterior capsulotenodesis (B&R group) and were evaluated retrospectively, using pre- and postoperative WOSI (Western Ontario Shoulder Instability), EQ-5D (EuroQOL five dimensions), EQ-VAS (EuroQol-visual analogue scale) scores and Subjective Shoulder Value (SSV). The recurrence and re-operation rates were compared to a matched group with isolated arthroscopic Bankart repair (B group). RESULTS: The mean age was 25 years with an mean follow-up of 26 months. All mean scores improved with SSV of 90%. There was a mean deficit in external rotation at the side of 10°. One patient was treated with hydrodilatation for frozen shoulder. One patient had residual posterior discomfort but no apprehension in the B&R group compared to 5% persistent apprehension in the B group. In comparison, the recurrence and re-operation rates were 5% and 30% (p = 0.015), 5% and 35% (p = 0.005) in the B&R and B groups, respectively. CONCLUSIONS: This combined technique demonstrated good outcomes, with lower recurrence rates in high-risk collision athletes. The slight restriction in external rotation does not significantly affect any clinical outcomes and return to play.
BACKGROUND: The present study aimed to determine whether arthroscopic remplissage with Bankart repair is an effective treatment for improving outcomes for collision athletes with Bankart and non-engaging Hill-Sachs lesions. METHODS: Twenty collision athletes underwent arthroscopic Bankart repair with posterior capsulotenodesis (B&R group) and were evaluated retrospectively, using pre- and postoperative WOSI (Western Ontario Shoulder Instability), EQ-5D (EuroQOL five dimensions), EQ-VAS (EuroQol-visual analogue scale) scores and Subjective Shoulder Value (SSV). The recurrence and re-operation rates were compared to a matched group with isolated arthroscopic Bankart repair (B group). RESULTS: The mean age was 25 years with an mean follow-up of 26 months. All mean scores improved with SSV of 90%. There was a mean deficit in external rotation at the side of 10°. One patient was treated with hydrodilatation for frozen shoulder. One patient had residual posterior discomfort but no apprehension in the B&R group compared to 5% persistent apprehension in the B group. In comparison, the recurrence and re-operation rates were 5% and 30% (p = 0.015), 5% and 35% (p = 0.005) in the B&R and B groups, respectively. CONCLUSIONS: This combined technique demonstrated good outcomes, with lower recurrence rates in high-risk collision athletes. The slight restriction in external rotation does not significantly affect any clinical outcomes and return to play.
Authors: Lennart Hovelius; Anders Olofsson; Björn Sandström; Bengt-Göran Augustini; Lars Krantz; Hans Fredin; Bo Tillander; Ulf Skoglund; Björn Salomonsson; Jan Nowak; Ulf Sennerby Journal: J Bone Joint Surg Am Date: 2008-05 Impact factor: 5.284
Authors: Jeffrey L Horinek; Mariano E Menendez; Jonathan J Callegari; Pablo Narbona; Alexandre Lädermann; Johannes Barth; Patrick J Denard Journal: Arthrosc Sports Med Rehabil Date: 2022-06-04