Arthroscopic Bankart and Remplissage for Anteroinferior Instability With Subcritical Bone Loss Has a Low Recurrence Rate

Abstract

Objective

To demonstrate whether arthroscopic remplissage can achieve good outcomes without significantly impairing shoulder function.

Methods

Consecutive patients with recurrent anterior glenohumeral dislocation, glenoid bone loss <20%, and engaging Hill–Sachs lesion who were operated with arthroscopic Bankart repair and remplissage between 2013 and 2016 were identified. Patients were evaluated clinically for shoulder instability, range of motion, and scored as per Oxford Shoulder Instability Score and University of California at Los Angeles score. The data were analyzed with the paired t test and the Wilcoxon signed rank test, as applicable. For all analyses, statistical significance was set at P < .05.

Results

Twenty-four patients were included in the study. The average age of the patients was 30 years (range, 18-47 years), with 91.67% (n = 22) male patients and 8.33% (n = 2) female patients. The range of motion at follow-up was comparable with the normal side, with loss of external rotation of 3.33° (n = 24). Significant improvement was observed in the Oxford Shoulder Instability Score (21.95 vs 41.29, P < 0.001) and University of California at Los Angeles score (18.33 vs 30.29, P < .001). A failure rate of 4.17% (1 patient with a positive apprehension test) was seen.

Conclusions

Arthroscopic Bankart repair with the remplissage procedure helps to re-establish stability and achieve good shoulder outcomes for patients with recurrent anterior glenohumeral dislocation and an engaging Hill–Sachs lesion and without significant glenoid bone loss.

Level of Evidence

Level IV, therapeutic.