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. 2019 Feb;11(1):17-25.
doi: 10.1177/1758573217728414. Epub 2017 Aug 23.

Arthroscopic Bankart repair with remplissage for non-engaging Hill-Sachs lesion in professional collision athletes

Peter Domos  1 , Francesco Ascione  2 , Andrew L Wallace  3
Affiliations

Arthroscopic Bankart repair with remplissage for non-engaging Hill-Sachs lesion in professional collision athletes

Peter Domos et al. Shoulder Elbow. 2019 Feb.

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.

Keywords: Bankart repair; athlete; non-engaging Hill-Sachs; remplissage; shoulder instability.

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Figures

Figure 1.
Figure 1.
(a) Sagittal computed tomography image of the glenoid and (b) three-dimensional reformat reveal another small bony Bankart lesion following a traumatic redislocation in the arthroscopic Bankart repair with posterior capsulotenodesis group.
Figure 2.
Figure 2.
(a) Axial computed tomography image of the shoulder and (b) three-dimensional reformat show the previous Hill-Sachs remplissage without any sign of re-injury in the same shoulder.
See this image and copyright information in PMC

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