Results of arthroscopic Bankart repair with Hill-Sachs remplissage for anterior shoulder instability

摘要

Abstract Purpose The aim of this study was to evaluate mid-term outcomes of Bankart repair with Hill-Sachs remplissage (BHSR) and to highlight prognostic factors of failure. Methods Thirty-four patients operated on for anterior shoulder instability with BHSR were enrolled in a prospective non-randomised study. Clinical and radiographic evaluation was performed at 1.5, three, six?months and yearly thereafter. Outcome measures included Rowe and Walch-Duplay score. Results At mean follow-up of 35?months (24–63), the Rowe and Walch-Duplay scores reached respectively 92.7 and 88.2 points. The mean deficit in external rotation was 6° in ER1 and 1° in ER2 ( p ?=?0.4, p ?=?0.9 respectively). Five patients (14.7%) had a recurrence of instability and three others had a persistent anterior apprehension. In the failure group, the Hill-Sachs lesion was deeper (26% vs 19% of the humeral diameter; p ?=?0.04) and range of motion at 1.5?months postoperatively was greater. Age at surgery, pre-operative instability severity index score (ISIS), hyperlaxity, type and level of sport, amount of glenoid bone loss had no correlation with failure rate. Conclusions The rate of failure at mid-term follow-up of BHSR was higher than commonly reported. The premature recovery of range of motion seems to be a clinical sign of failure at follow-up. Moreover, in case of deep Hill-Sachs lesion (>20%) an alternative procedure should be considered. Level of evidence Level IV.