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. 2020 Feb 27;8(2):2325967120903283.
doi: 10.1177/2325967120903283. eCollection 2020 Feb.

What Are the Effects of Remplissage on 6-Month Strength and Range of Motion After Arthroscopic Bankart Repair? A Multicenter Cohort Study

Travis L Frantz  1 , Joshua S Everhart  1 , Gregory L Cvetanovich  1 , Andrew Neviaser  1 , Grant L Jones  1 , Carolyn M Hettrich  1 , Brian R Wolf  1 ; MOON Shoulder Group; Julie Bishop  1 , Bruce Miller  1 , Robert H Brophy  1 , C Benjamin Ma  1 , Charlie L Cox  1 , Keith M Baumgarten  1 , Brian T Feeley  1 , Alan L Zhang  1 , Eric C McCarty  1 , John E Kuhn  1
Affiliations

What Are the Effects of Remplissage on 6-Month Strength and Range of Motion After Arthroscopic Bankart Repair? A Multicenter Cohort Study

Travis L Frantz et al. Orthop J Sports Med. .

Abstract

Background: Patients who have undergone shoulder instability surgery are often allowed to return to sports, work, and high-level activity based largely on a time-based criterion of 6 months postoperatively. However, some believe that advancing activity after surgery should be dependent on the return of strength and range of motion (ROM).

Hypothesis: There will be a significant loss of strength or ROM at 6 months after arthroscopic Bankart repair with remplissage compared with Bankart repair alone.

Study design: Cohort study; Level of evidence, 2.

Methods: A total of 38 patients in a prospective multicenter study underwent arthroscopic Bankart repair with remplissage (33 males, 5 females; mean age, 27.0 ± 10.2 years; 82% with ≥2 dislocation events in the past year). Strength and ROM were assessed preoperatively and at 6 months after surgery. Results were compared with 104 matched patients who had undergone Bankart repair without remplissage, although all had radiographic evidence of a Hill-Sachs defect.

Results: At 6 months, there were no patients in the remplissage group with anterior apprehension on physical examination. However, 26% had a ≥20° external rotation (ER) deficit with the elbow at the side, 42% had a ≥20° ER deficit with the elbow at 90° of abduction, and 5% had persistent weakness. Compared with matched patients who underwent only arthroscopic Bankart repair, the remplissage group had greater humeral bone loss and had a greater likelihood of a ≥20° ER deficit with the elbow at 90° of abduction (P = .004). Risk factors for a ≥20° ER deficit with the elbow at 90° of abduction were preoperative stiffness in the same plane (P = .02), while risk factors for a ≥20° ER deficit with the elbow at the side were increased number of inferior quadrant glenoid anchors (P = .003), increased patient age (P = .02), and preoperative side-to-side deficits in ER (P = .04). The only risk factor for postoperative ER weakness was preoperative ER weakness (P = .04), with no association with remplissage (P = .26).

Conclusion: Arthroscopic Bankart repair with remplissage did not result in significant strength deficits but increased the risk of ER stiffness in abduction compared with Bankart repair without remplissage at short-term follow-up.

Keywords: Bankart repair; ROM; remplissage; shoulder arthroscopic surgery; strength.

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Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: G.L.C. has received hospitality payments from Smith & Nephew, Zimmer Biomet, Arthrex, and CDC Medical. A.N. has received hospitality payments from DePuy Synthes and Encore Medical. G.L.J. has received hospitality payments from DJO, Encore Medical, the Musculoskeletal Transplant Foundation, and Smith & Nephew and honoraria from the Musculoskeletal Transplant Foundation. C.M.H. has received hospitality payments from Heraeus Medical, Zimmer Biomet, Smith & Nephew, and Wright Medical Technology. B.R.W. has received hospitality payments from Arthrex, DJO, Vericel, and Wright Medical Technology and consulting fees from Linvatec. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

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