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

摘要

PurposeThe evaluation of the long-term outcome of the arthroscopic remplissage performed in addition to the classic Bankart repair for the primary management of recurrent anterior shoulder instability with engaging Hill-Sachs lesion without inverted pear appearance of the glenoid during arthroscopy.MethodsDuring a 6-year period, from 2007 to 2012, 65 patients whose average age was 30.17.6years were operated on in our department and satisfied the inclusion criteria of this study. They all had a positive apprehension sign preoperatively. Among them, 51 patients (82%) were available for long-term evaluation. The mean follow-up period was 8.11.8years (range 5.6-10.6).ResultsThree patients (5.6%) had suffered a new dislocation. The remaining patients (94.4%) were satisfied with the surgical result and returned to their previous daily activities, whereas 71% continued to participate in sports without restrictions. The ASES score increased from 72.5 (range 18-100) preoperatively to 100 (range 85-100) postoperatively (p<0.01). The modified Rowe score increased from 40 (range 15-70) to 100 (range 70-100) (p<0.001), and the Oxford Instability score from 29 (range 9-47) to 48 (range 36-48) (p<0.001). No significant restriction in the shoulder range of motion was documented.ConclusionsThe combination of the arthroscopic remplissage with the classic Bankart repair was proven to be a safe and effective procedure for the treatment of engaging Hill-Sachs lesions without inverted pear appearance of the glenoid. This combination has long-term outcomes in terms of the recurrence rate and does not significantly influence the range of motion of the shoulder.