Results of Arthroscopic Remplissage with Bankart Repair for the Management of Glenohumeral Instability with Hill-Sachs Bone Defect

Abdelsamie Mohammed Halawa; Mohammed Aboalata

doi:doi:10.11648/j.ajbls.20221002.12

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Results of Arthroscopic Remplissage with Bankart Repair for the Management of Glenohumeral Instability with Hill-Sachs Bone Defect

Abdelsamie Mohammed Halawa, Mohammed Aboalata

Published in American Journal of Biomedical and Life Sciences (Volume 10, Issue 2)

Received: 21 January 2022 Accepted: 28 February 2022 Published: 15 March 2022

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Abstract

Glenohumeral joint instability is one of the commonest disorders of the shoulder as it has a great range of motion on the expense of stability as refered to the bony configuration of the joint. Instability may be traumatic or atraumatic and uni-directional or multidirectional with wide range of patient complaints from mild pain in micro-instability to obvious dislocation. The most commonly used arthroscopic procedure include filling the humeral head defect by capsulo-tenodesis of the infraspinatus tendon and posterior capsule (Remplissage). The aim of this study was to present our results of Bankart repair and Reimplissage in management of recurrent shoulder instability with Hill-Sachs lesions. 20 young, middle age and fit patients with recurrent anterior shoulder dislocation with combined Bankart lesion and Hill-Sachs lesion. All Hill-Sachs lesions were large or engaging (Calandra grade 3 at time of arthroscopy) and all were managed by arthroscopic Bankart repair combined with Remplissage. When compared to pre-operative ROM, a statistically significant difference was found in the mean increase of anterior elevation by 2°, external rotation (ER) side by 4◦ and 5° for ER at 90° abduction at final follow-up (p value < 0.001). There were statistically significant difference in the mean decrease of 5° and 10° in ER side and ER at 90° abduction respectively at final follow-up compared to normal side ROM (p value < 0.001), also significant decrease in anterior elevation by 4° and IR at 90° abduction by 2° (p value < 0.001) which were not comparable to other studies but was clinically insignificant. The mean final Rowe and SST scores were 85 and 11.35 respectively indicating a statistically significant difference in mean increase of both the total Rowe and total SST percentage score when compared to pre-operative scores (p value < 0.001). All patients were followed prospectively for a minimum of 12 months. Conclusion: arthroscopic Bankart repair and remplissage is an effective means of managing shoulder instability in patients with large Hill-Sachs lesions and no significant glenoid bony defect.

Published in	American Journal of Biomedical and Life Sciences (Volume 10, Issue 2)
DOI	10.11648/j.ajbls.20221002.12
Page(s)	21-27
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Shoulder Instability, Remplissage, Hill-Sachs

References

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[2]	Burkhart SS, De Beer JFB. Traumatic glenohumeral bone defects and their relationship to failure arthroscopic Bankart repairs: significance of inverted pear glenoid and the humeral engaging Hill-Sachs lesion. Arthroscopy. 2000; 16-7: 677-94.
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[4]	Yamamoto N, Itoi E, Abe H, et al. Contact between the glenoid and the humeral head in abduction, external rotation, and horizontal extension: a new concept of glenoid track. J Shoulder Elbow Surg. 2007; 16: 649-656.
[5]	Purchase RJ, Wolf EM, Hobgood ER, Pollock ME, Smalley CC. Hill-Sachs "remplissage": an arthroscopic solution for the engaging Hill-Sachs lesion. Arthroscopy. 2008; 24 (6): 723-726.
[6]	Weber BG, Simpson LA, Hardegger F. Rotational humeral osteotomy for recurrent anterior dislocation of the shoulder associated with large Hill-Sachs lesion. J Bone Joint Surg Am. 1984; 66: 1443-1450.
[7]	Miniaci A, Berlet G. Recurrent anterior instability following failed surgical repair: Allograft reconstruction of large humeral head defects. J Bone Joint Surg Br. 2001; 83 (Suppl 1): 19-20.
[8]	Kazel MD, Sekiya JK, Greene JA, Bruker CT. Percutaneous correction (humeroplasty) of humeral head defects (Hill-Scahs) associated with anteriro shoulder instability: a cadaveric study. Arthroscopy. 2005; 12: 1473-1478.
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[13]	Itoi E, Lee S, Berglund LJ, Berge LL, An K. The effect of a glenoid defect on anteroinferior stability of the shoulder after Bankart repair: a cadaveric study. J Bone Joint Surg. 2000; 82A: 35–46.
[14]	Sekiya JK, Jolly J, Debski RE. The effect of a Hill-Sachs defect on glenohumeral translations, in situ capsular forces, and bony contact forces. Am J Sports Med. 2012; 40 (2): 388–394.
[15]	Provencher M, Bhatia S, Ghodadra N, Grumet R, Bach B Jr, Dewing C et al. Recurrent shoulder instability: current concepts for evaluation and management of glenoid bone loss. J Bone Joint Surg Am. 2010; 92 (Suppl 2): 133–151.
[16]	Nourissat G, Kilinc AS, Werther JR, et al. A prospective, comparative, radiological, and clinical study of the influence of the “Remplissage” procedure on shoulder range of motion after stabilization by arthroscopic Bankart repair. Am J Sports Med 2011; 39: 2147-52.
[17]	Deutsh AA, Kroll DG. Decreased range of motion following arthroscopic remplissage. Orthopedics 2008; 31: 492.

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Abdelsamie Mohammed Halawa, Mohammed Aboalata. (2022). Results of Arthroscopic Remplissage with Bankart Repair for the Management of Glenohumeral Instability with Hill-Sachs Bone Defect. American Journal of Biomedical and Life Sciences, 10(2), 21-27. https://doi.org/10.11648/j.ajbls.20221002.12

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Abdelsamie Mohammed Halawa; Mohammed Aboalata. Results of Arthroscopic Remplissage with Bankart Repair for the Management of Glenohumeral Instability with Hill-Sachs Bone Defect. Am. J. Biomed. Life Sci. 2022, 10(2), 21-27. doi: 10.11648/j.ajbls.20221002.12

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AMA Style

Abdelsamie Mohammed Halawa, Mohammed Aboalata. Results of Arthroscopic Remplissage with Bankart Repair for the Management of Glenohumeral Instability with Hill-Sachs Bone Defect. Am J Biomed Life Sci. 2022;10(2):21-27. doi: 10.11648/j.ajbls.20221002.12

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@article{10.11648/j.ajbls.20221002.12,
  author = {Abdelsamie Mohammed Halawa and Mohammed Aboalata},
  title = {Results of Arthroscopic Remplissage with Bankart Repair for the Management of Glenohumeral Instability with Hill-Sachs Bone Defect},
  journal = {American Journal of Biomedical and Life Sciences},
  volume = {10},
  number = {2},
  pages = {21-27},
  doi = {10.11648/j.ajbls.20221002.12},
  url = {https://doi.org/10.11648/j.ajbls.20221002.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajbls.20221002.12},
  abstract = {Glenohumeral joint instability is one of the commonest disorders of the shoulder as it has a great range of motion on the expense of stability as refered to the bony configuration of the joint. Instability may be traumatic or atraumatic and uni-directional or multidirectional with wide range of patient complaints from mild pain in micro-instability to obvious dislocation. The most commonly used arthroscopic procedure include filling the humeral head defect by capsulo-tenodesis of the infraspinatus tendon and posterior capsule (Remplissage). The aim of this study was to present our results of Bankart repair and Reimplissage in management of recurrent shoulder instability with Hill-Sachs lesions. 20 young, middle age and fit patients with recurrent anterior shoulder dislocation with combined Bankart lesion and Hill-Sachs lesion. All Hill-Sachs lesions were large or engaging (Calandra grade 3 at time of arthroscopy) and all were managed by arthroscopic Bankart repair combined with Remplissage. When compared to pre-operative ROM, a statistically significant difference was found in the mean increase of anterior elevation by 2°, external rotation (ER) side by 4◦ and 5° for ER at 90° abduction at final follow-up (p value < 0.001). There were statistically significant difference in the mean decrease of 5° and 10° in ER side and ER at 90° abduction respectively at final follow-up compared to normal side ROM (p value < 0.001), also significant decrease in anterior elevation by 4° and IR at 90° abduction by 2° (p value < 0.001) which were not comparable to other studies but was clinically insignificant. The mean final Rowe and SST scores were 85 and 11.35 respectively indicating a statistically significant difference in mean increase of both the total Rowe and total SST percentage score when compared to pre-operative scores (p value < 0.001). All patients were followed prospectively for a minimum of 12 months. Conclusion: arthroscopic Bankart repair and remplissage is an effective means of managing shoulder instability in patients with large Hill-Sachs lesions and no significant glenoid bony defect.},
 year = {2022}
}

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TY  - JOUR
T1  - Results of Arthroscopic Remplissage with Bankart Repair for the Management of Glenohumeral Instability with Hill-Sachs Bone Defect
AU  - Abdelsamie Mohammed Halawa
AU  - Mohammed Aboalata
Y1  - 2022/03/15
PY  - 2022
N1  - https://doi.org/10.11648/j.ajbls.20221002.12
DO  - 10.11648/j.ajbls.20221002.12
T2  - American Journal of Biomedical and Life Sciences
JF  - American Journal of Biomedical and Life Sciences
JO  - American Journal of Biomedical and Life Sciences
SP  - 21
EP  - 27
PB  - Science Publishing Group
SN  - 2330-880X
UR  - https://doi.org/10.11648/j.ajbls.20221002.12
AB  - Glenohumeral joint instability is one of the commonest disorders of the shoulder as it has a great range of motion on the expense of stability as refered to the bony configuration of the joint. Instability may be traumatic or atraumatic and uni-directional or multidirectional with wide range of patient complaints from mild pain in micro-instability to obvious dislocation. The most commonly used arthroscopic procedure include filling the humeral head defect by capsulo-tenodesis of the infraspinatus tendon and posterior capsule (Remplissage). The aim of this study was to present our results of Bankart repair and Reimplissage in management of recurrent shoulder instability with Hill-Sachs lesions. 20 young, middle age and fit patients with recurrent anterior shoulder dislocation with combined Bankart lesion and Hill-Sachs lesion. All Hill-Sachs lesions were large or engaging (Calandra grade 3 at time of arthroscopy) and all were managed by arthroscopic Bankart repair combined with Remplissage. When compared to pre-operative ROM, a statistically significant difference was found in the mean increase of anterior elevation by 2°, external rotation (ER) side by 4◦ and 5° for ER at 90° abduction at final follow-up (p value < 0.001). There were statistically significant difference in the mean decrease of 5° and 10° in ER side and ER at 90° abduction respectively at final follow-up compared to normal side ROM (p value < 0.001), also significant decrease in anterior elevation by 4° and IR at 90° abduction by 2° (p value < 0.001) which were not comparable to other studies but was clinically insignificant. The mean final Rowe and SST scores were 85 and 11.35 respectively indicating a statistically significant difference in mean increase of both the total Rowe and total SST percentage score when compared to pre-operative scores (p value < 0.001). All patients were followed prospectively for a minimum of 12 months. Conclusion: arthroscopic Bankart repair and remplissage is an effective means of managing shoulder instability in patients with large Hill-Sachs lesions and no significant glenoid bony defect.
VL  - 10
IS  - 2
ER  -

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Author Information

Abdelsamie Mohammed Halawa

Department of Orthopedics, Benha University, Benha City, Egypt
Mohammed Aboalata

Department of Orthopedics, Mansoura University, Mansoura City, Egypt

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APA Style

Abdelsamie Mohammed Halawa, Mohammed Aboalata. (2022). Results of Arthroscopic Remplissage with Bankart Repair for the Management of Glenohumeral Instability with Hill-Sachs Bone Defect. American Journal of Biomedical and Life Sciences, 10(2), 21-27. https://doi.org/10.11648/j.ajbls.20221002.12

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ACS Style

Abdelsamie Mohammed Halawa; Mohammed Aboalata. Results of Arthroscopic Remplissage with Bankart Repair for the Management of Glenohumeral Instability with Hill-Sachs Bone Defect. Am. J. Biomed. Life Sci. 2022, 10(2), 21-27. doi: 10.11648/j.ajbls.20221002.12

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AMA Style

Abdelsamie Mohammed Halawa, Mohammed Aboalata. Results of Arthroscopic Remplissage with Bankart Repair for the Management of Glenohumeral Instability with Hill-Sachs Bone Defect. Am J Biomed Life Sci. 2022;10(2):21-27. doi: 10.11648/j.ajbls.20221002.12

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@article{10.11648/j.ajbls.20221002.12,
  author = {Abdelsamie Mohammed Halawa and Mohammed Aboalata},
  title = {Results of Arthroscopic Remplissage with Bankart Repair for the Management of Glenohumeral Instability with Hill-Sachs Bone Defect},
  journal = {American Journal of Biomedical and Life Sciences},
  volume = {10},
  number = {2},
  pages = {21-27},
  doi = {10.11648/j.ajbls.20221002.12},
  url = {https://doi.org/10.11648/j.ajbls.20221002.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajbls.20221002.12},
  abstract = {Glenohumeral joint instability is one of the commonest disorders of the shoulder as it has a great range of motion on the expense of stability as refered to the bony configuration of the joint. Instability may be traumatic or atraumatic and uni-directional or multidirectional with wide range of patient complaints from mild pain in micro-instability to obvious dislocation. The most commonly used arthroscopic procedure include filling the humeral head defect by capsulo-tenodesis of the infraspinatus tendon and posterior capsule (Remplissage). The aim of this study was to present our results of Bankart repair and Reimplissage in management of recurrent shoulder instability with Hill-Sachs lesions. 20 young, middle age and fit patients with recurrent anterior shoulder dislocation with combined Bankart lesion and Hill-Sachs lesion. All Hill-Sachs lesions were large or engaging (Calandra grade 3 at time of arthroscopy) and all were managed by arthroscopic Bankart repair combined with Remplissage. When compared to pre-operative ROM, a statistically significant difference was found in the mean increase of anterior elevation by 2°, external rotation (ER) side by 4◦ and 5° for ER at 90° abduction at final follow-up (p value < 0.001). There were statistically significant difference in the mean decrease of 5° and 10° in ER side and ER at 90° abduction respectively at final follow-up compared to normal side ROM (p value < 0.001), also significant decrease in anterior elevation by 4° and IR at 90° abduction by 2° (p value < 0.001) which were not comparable to other studies but was clinically insignificant. The mean final Rowe and SST scores were 85 and 11.35 respectively indicating a statistically significant difference in mean increase of both the total Rowe and total SST percentage score when compared to pre-operative scores (p value < 0.001). All patients were followed prospectively for a minimum of 12 months. Conclusion: arthroscopic Bankart repair and remplissage is an effective means of managing shoulder instability in patients with large Hill-Sachs lesions and no significant glenoid bony defect.},
 year = {2022}
}

Copy | Download

TY  - JOUR
T1  - Results of Arthroscopic Remplissage with Bankart Repair for the Management of Glenohumeral Instability with Hill-Sachs Bone Defect
AU  - Abdelsamie Mohammed Halawa
AU  - Mohammed Aboalata
Y1  - 2022/03/15
PY  - 2022
N1  - https://doi.org/10.11648/j.ajbls.20221002.12
DO  - 10.11648/j.ajbls.20221002.12
T2  - American Journal of Biomedical and Life Sciences
JF  - American Journal of Biomedical and Life Sciences
JO  - American Journal of Biomedical and Life Sciences
SP  - 21
EP  - 27
PB  - Science Publishing Group
SN  - 2330-880X
UR  - https://doi.org/10.11648/j.ajbls.20221002.12
AB  - Glenohumeral joint instability is one of the commonest disorders of the shoulder as it has a great range of motion on the expense of stability as refered to the bony configuration of the joint. Instability may be traumatic or atraumatic and uni-directional or multidirectional with wide range of patient complaints from mild pain in micro-instability to obvious dislocation. The most commonly used arthroscopic procedure include filling the humeral head defect by capsulo-tenodesis of the infraspinatus tendon and posterior capsule (Remplissage). The aim of this study was to present our results of Bankart repair and Reimplissage in management of recurrent shoulder instability with Hill-Sachs lesions. 20 young, middle age and fit patients with recurrent anterior shoulder dislocation with combined Bankart lesion and Hill-Sachs lesion. All Hill-Sachs lesions were large or engaging (Calandra grade 3 at time of arthroscopy) and all were managed by arthroscopic Bankart repair combined with Remplissage. When compared to pre-operative ROM, a statistically significant difference was found in the mean increase of anterior elevation by 2°, external rotation (ER) side by 4◦ and 5° for ER at 90° abduction at final follow-up (p value < 0.001). There were statistically significant difference in the mean decrease of 5° and 10° in ER side and ER at 90° abduction respectively at final follow-up compared to normal side ROM (p value < 0.001), also significant decrease in anterior elevation by 4° and IR at 90° abduction by 2° (p value < 0.001) which were not comparable to other studies but was clinically insignificant. The mean final Rowe and SST scores were 85 and 11.35 respectively indicating a statistically significant difference in mean increase of both the total Rowe and total SST percentage score when compared to pre-operative scores (p value < 0.001). All patients were followed prospectively for a minimum of 12 months. Conclusion: arthroscopic Bankart repair and remplissage is an effective means of managing shoulder instability in patients with large Hill-Sachs lesions and no significant glenoid bony defect.
VL  - 10
IS  - 2
ER  -

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