Clinical Outcome of Arthroscopic Remplissage as Augmentation During Arthroscopic Bankart Repair for Recurrent Anterior Shoulder Instability

Bentham Science Publishers Ltd. - Tập 11 Số 1 - Trang 1268-1276 - 2017
Ryosuke Miyamoto1, Atsushi Yamamoto1, Hitoshi Shitara1, Tsuyoshi Ichinose1, Daisuke Shimoyama2, Tsuyoshi Sasaki1, Noritaka Hamano1, Tsutomu Kobayashi3, Toshihisa Osawa4, Kenji Takagishi2
1Gunma University Graduate School of Medicine -Orthopaedic Surgery, Maebashi, Gunma, Japan
2St. Pierre Hospital -Orthopaedic Surgery, Takasaki, Gunma, Japan
3Takasaki University of Health and Welfare -Physical Therapy, Takasaki, Gunma, Japan
4National Hospital Organization Takasaki General Medical Center -Orthopaedic Surgery, Takasaki, Gunma, Japan

Tóm tắt

Purpose:We aimed to assess functional outcomes and postoperative recurrence rate associated with the remplissage procedure used for bone augmentation with Bankart repair in patients with Hill-Sachs lesions after shoulder dislocation.Methods:Preoperative computed tomography was performed to check for bony Bankart lesions,calculate the bone defect rate, and estimate the risk for re-dislocation. Functional and clinical scores were assessed preoperatively and at three months, six months, and one year postoperatively.Results:Between 2011 and 2014, 18 patients (17 male; age at surgery, 29.0±10.4 years; 18 affected shoulders) underwent arthroscopic Bankart repair with arthroscopic remplissage (remplissage group), and 18 sex- and age-matched controls underwent arthroscopic Bankart repair alone (control group). The incidence of bony Bankart lesion and glenoid bone defect was significantly higher in the remplissage group. No complications, re-dislocation, or re-subluxation was noted during or after the operation. Postoperatively, the range of motion and muscular weakness alleviated with time, and the clinical scores improved significantly from the preoperative values. However, the remplissage group showed significantly restricted shoulder flexion, abduction, internal rotation and external rotation even at one year postoperatively. Compared to the control group, the remplissage group showed significantly lower Rowe scores preoperatively, and both Rowe scores and University of California-Los Angeles scale scores remained significantly lower throughout the one-year follow-up.Conclusion:Despite some restriction of external rotation, remplissage leads to better clinical scores and no recurrence, providing a valid means of augmentation for Bankart repair in high-risk patients with engaged Hill-Sachs lesion.

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Tài liệu tham khảo

Petrera M, Patella V, Patella S, Theodoropoulos J. A meta-analysis of open versus arthroscopic Bankart repair using suture anchors. Knee Surg Sports Traumatol Arthrosc 2010; 18 (12) : 1742-7.

Zhang AL, Montgomery SR, Ngo SS, Hame SL, Wang JC, Gamradt SC. Arthroscopic versus open shoulder stabilization: current practice patterns in the United States. Arthroscopy 2014; 30 (4) : 436-43.

Widjaja AB, Tran A, Bailey M, Proper S. Correlation between Bankart and Hill-Sachs lesions in anterior shoulder dislocation. ANZ J Surg 2006; 76 (6) : 436-8.

Burkhart SS, De Beer JF. Traumatic glenohumeral bone defects and their relationship to failure of arthroscopic Bankart repairs: Significance of the inverted-pear glenoid and the humeral engaging Hill-Sachs lesion. Arthroscopy 2000; 16 (7) : 677-94.

Di Giacomo G, De Vita A, Costantini A, de Gasperis N, Scarso P. Management of humeral head deficiencies and glenoid track. Curr Rev Musculoskelet Med 2014; 7 (1) : 6-11.

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 (5) : 649-56.

Connolly JF. Humeral head defects associated with shoulder dislocation—Their diagnostic and surgical significance. Instr Course Lect 1972; 21 : 42-54.

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) : 723-6.

Yamamoto N, Kijima H, Nagamoto H, et al. Outcome of Bankart repair in contact versus non-contact athletes. Orthop Traumatol Surg Res 2015; 101 (4) : 415-9.

Longo UG, Loppini M, Rizzello G, et al. Remplissage, humeral osteochondral grafts, weber osteotomy, and shoulder arthroplasty for the management of humeral bone defects in shoulder instability: Systematic review and quantitative synthesis of the literature. Arthroscopy 2014; 30 (12) : 1650-66.

Garcia GH, Park MJ, Zhang C, Kelly JD IV, Huffman GR. Large Hill-Sachs Lesion: A comparative study of patients treated with arthroscopic bankart repair with or without remplissage. HSS J 2015; 11 (2) : 98-103.

Cho NS, Yoo JH, Rhee YG. Management of an engaging Hill-Sachs lesion: Arthroscopic remplissage with Bankart repair versus Latarjet procedure. Knee Surg Sports Traumatol Arthrosc 2016; 24 (12) : 3793-800.

Sugaya H, Kon Y, Tsuchiya A. Arthroscopic Bankart repair in the beachchair position: A cannulaless method using an intra-articular suture relay technique. Arthroscopy 2004; 20 (Suppl. 2) : 116-20.

Boileau P, Villalba M, Héry JY, Balg F, Ahrens P, Neyton L. Risk factors for recurrence of shoulder instability after arthroscopic Bankart repair. J Bone Joint Surg Am 2006; 88 (8) : 1755-63.

Uhring J, Rey PB, Rochet S, Obert L. Interest of emergency arthroscopic stabilization in primary shoulder dislocation in young athletes. Orthop Traumatol Surg Res 2014; 100 (8) (Suppl.) : S401-8.

Petrera M, Dwyer T, Tsuji MR, Theodoropoulos JS. Outcomes of arthroscopic Bankart repair in collision versus noncollision athletes. Orthopedics 2013; 36 (5) : e621-6.

Butt U, Charalambous CP. Complications associated with open coracoid transfer procedures for shoulder instability. J Shoulder Elbow Surg 2012; 21 (8) : 1110-9.

Shah AA, Butler RB, Romanowski J, Goel D, Karadagli D, Warner JJ. Short-term complications of the Latarjet procedure. J Bone Joint Surg Am 2012; 94 (6) : 495-501.

Buza JA III, Iyengar JJ, Anakwenze OA, Ahmad CS, Levine WN. Arthroscopic Hill-Sachs remplissage: A systematic review. J Bone Joint Surg Am 2014; 96 (7) : 549-55.

Garcia GH, Wu HH, Liu JN, Huffman GR, Kelly JD IV. Outcomes of the Remplissage Procedure and Its Effects on Return to Sports: Average 5-Year Follow-up. Am J Sports Med 2016; 44 (5) : 1124-30.

Grimberg J, Diop A, Bou Ghosn R, Lanari D, Canonne A, Maurel N. Bankart repair versus Bankart repair plus remplissage: An in vitro biomechanical comparative study. Knee Surg Sports Traumatol Arthrosc 2016; 24 (2) : 374-80.

Zhu YM, Lu Y, Zhang J, Shen JW, Jiang CY. Arthroscopic Bankart repair combined with remplissage technique for the treatment of anterior shoulder instability with engaging Hill-Sachs lesion: A report of 49 cases with a minimum 2-year follow-up. Am J Sports Med 2011; 39 (8) : 1640-7.

Boileau P, O’Shea K, Vargas P, Pinedo M, Old J, Zumstein M. Anatomical and functional results after arthroscopic Hill-Sachs remplissage. J Bone Joint Surg Am 2012; 94 (7) : 618-26.

Cho NS, Yoo JH, Juh HS, Rhee YG. Anterior shoulder instability with engaging Hill-Sachs defects: A comparison of arthroscopic Bankart repair with and without posterior capsulodesis. Knee Surg Sports Traumatol Arthrosc 2015.

Nourissat G, Kilinc AS, Werther JR, Doursounian L. 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 (10) : 2147-52.

Lädermann A, Arrigoni P, Barth J, et al. Is arthroscopic remplissage a tenodesis or capsulomyodesis? An anatomic study. Knee Surg Sports Traumatol Arthrosc 2016; 24 (2) : 573-7.

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Bentham Science Publishers Ltd.

Tập 11 Số 1

1268-1276

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