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Arthroscopic remplissage likely effective in repairing Hill-Sachs lesions
Recently published data demonstrated arthroscopic remplissage was an effective way to repair Hill-Sachs lesions, with quality of life not significantly affected by internal and external rotation restriction.
Researchers retrospectively compared 61 patients who underwent arthroscopic Bankart repair and Hill-Sachs remplissage at a minimum of 24 months previously with 40 healthy patients comprising a control group. The researchers identified Bankart lesions utilizing preoperative MRIs, and CT images were used to determine the number of humeral head defects. Additionally, the researchers assessed patients’ range of motion and clinical scores with Walch-Duplay, Constant-Murley and Rowe.
The infraspinatus strength test (IST) and the infraspinatus scapula retraction test (ISRT) were used to assess infraspinatus strength. To measure internal (IR) rotation and external rotation (ER), patients’ arms were positioned at the sides (IR1, ER1) and abducted 90° (IR2, ER2). Ultrasounds were also utilized to evaluate infraspinatus tendodesis and posterior capsulodesis healing. Median follow-up was 39.5 months.
Results showed one patient after 34 months frequently experienced instability. Patients who underwent remplissage were observed to have significantly lower ER in the affected shoulder vs. the unaffected shoulder. However, none of the differences in the other measurements were considered significant, according to the researchers.
The researchers found mean IST and ISRT strength values were not different between sides.
Twenty-three patients were found to have excellent Walch-Duplay and Rowe scores; six patients were rated as good and one was rated as poor.
Compared with the control group, patients who underwent remplissage had significantly lower ER1, ER2 and IR2 scores, according to the researchers.
The researchers also reported all patients were confirmed to have capsulotenodesis healing and Hill-Sachs lesions filled. ‒ by Monica Jaramillo
Disclosures: The researchers report no relevant financial disclosures.