Bankart repair with remplissage may lower recurrent dislocation rate in Hill-Sachs lesions
Click Here to Manage Email Alerts
Key takeaways:
- Contact athletes and patients with near-track lesions were considered high-risk for recurrent dislocation.
- Patients high-risk for recurrent dislocation had a lower rate of recurrent dislocation with remplissage.
NEW ORLEANS — Results presented here showed arthroscopic labral repair with remplissage had a lower recurrent dislocation rate among patients with on-track Hill-Sachs lesions.
Aaron E. Barrow, MD, and colleagues categorized patients with on-track Hill-Sachs lesions into groups based on whether they underwent Bankart repair with or without remplissage. Researchers collected age, gender, follow-up and contact sport participation, and determined glenoid bone loss, Hill-Sachs interval, glenoid track and distance to dislocation from preoperative MRIs. Researchers also collected shoulder range of motion, Western Ontario Shoulder Instability Index (WOSI) scores, subjective shoulder value (SSV) scores and recurrent dislocation and revision surgery status.
“Looking at baseline characteristics between the two cohorts showed that demographics, preoperative range of motion and patient outcome scores were no different between the two groups,” Barrow said about research that received the Richard J. O’Connor, MD, Research Award at the Arthroscopy Association of North America Annual Meeting. “However, importantly, all measures of bone loss, including glenoid bone loss, Hill-Sachs interval and distance to dislocation, were all more severe in the remplissage cohort compared to the Bankart cohort.”
Barrow noted recurrent dislocation was significantly different between the two groups, with one recurrent dislocation in the remplissage group vs. 14 in the Bankart group. He added the remplissage group and Bankart group had no significant differences in revision surgery, return to sport or shoulder range of motion.
“We then did a subgroup analysis looking at patients that we considered to be the highest risk of recurrent dislocation, including contact sport athletes and patients with a distance to dislocation less than 10 mm, in other words a near-track lesion,” Barrow said.
Contact athletes had a recurrent dislocation rate of 21% in the Bankart group and of 3% in the remplissage group, and patients with a near-track lesion had a recurrent dislocation rate of 35% in the Bankart group and 2% in the remplissage group, according to Barrow. He added contact athletes with near-track lesions had a recurrent dislocation rate of 67% in the Bankart group vs. 4% in the remplissage group.
“While we didn’t show a difference in patient outcome score between the cohorts, overall, when you look at patients with a near-track lesion and the contact athletes who had a near-track lesion, there was significantly improved WOSI and SSV scores at final follow-up for the remplissage cohort,” Barrow said.
Collapse
Barrow AE, et al. Remplissage reduces recurrent instability in high-risk patients with ‘on-track’ Hill-Sachs Lesions. Presented at: Arthroscopy Association of North America Annual Meeting; May 4-6, 2023; New Orleans.
Read more about
Click Here to Manage Email Alerts