Bankart repair versus Bankart repair plus remplissage: an in vitro biomechanical comparative study

Grimberg, Jean; Diop, Amadou Gallo; Ghosn, Rosny Bou; Lanari, Dimitri; Canonne, A.M.; Maurel, Nathalie

doi:10.1007/s00167-014-3052-z

Cited by 39 publications

(21 citation statements)

References 38 publications

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“…Restriction of ROM represents a shortcoming of remplissage, as described in many reports, and it results from the fact that remplissage is a technique of non-anatomical repair whereby the Hill-Sachs lesion is filled by advancing the posterior articular capsule and the infraspinatus muscle tendon; the new footprint is located closer to the posterior articular cavity edge, which can cause ROM restriction (particularly restriction of external rotation). The biomechanical study of Grimberg et al found that patients who underwent remplissage showed an 11.7° restriction of external rotation ROM, which differed significantly from that noted in patients who underwent Bankart repair alone [ 21 ]. Zhu et al reported an average improvement in flexion by 8° and restriction of external rotation by 1.9°, but these differences were not statistically significant [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

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

Miyamoto

Yamamoto

Shitara

et al. 2017

TOORTHJ

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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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Section: Discussionmentioning

confidence: 99%

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

Miyamoto

Yamamoto

Shitara

et al. 2017

TOORTHJ

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“…In their 2000 article, Burkhart and De Beer 3 reported that arthroscopic Bankart repair patients with bony defects were at a greater risk of recurrent dislocation. This has been echoed in subsequent studies 20, 21, 22, 23, 24. Currently, arthroscopic Bankart repair and the open Latarjet procedure are the preferred surgical techniques when addressing recurrent shoulder dislocation.…”

Section: Discussionmentioning

confidence: 95%

Arthroscopic Double-Pulley Remplissage Using a 2-Portal Technique for Hill-Sachs Lesions in Recurrent Anterior Shoulder Instability

Chakrabarti¹,

Gwosdz²,

Rosinski³

et al. 2019

Arthroscopy Techniques

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Hill-Sachs lesions of the humeral head are associated with recurrent anterior shoulder instability. Arthroscopic double-pulley remplissage has emerged as the leading alternative to the open Latarjet procedure to address recurrent shoulder instability with comparable recurrence rates and favorable complication rates. This Technical Note describes our adaptation of the double-pulley remplissage technique by using 2 portals, with the anterior portal used as the viewing portal and suture passage through the posterior portal. This technique eliminates the need for a lateral percutaneous portal, consequently minimizing operative time and postoperative morbidity. Furthermore, using the anterior portal as the viewing portal allows for direct visualization of the reduction of the infraspinatus into the Hill-Sachs defect. The drawback of this technique is that there is no view of the subacromial space during knot tying.

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“…Biomechanical studies on cadavers have reported loss of external rotation, including Grimberg et al, 19 who found a 11.7 loss in external rotation after Bankart plus remplissage compared with the intact cadaveric specimen; however, their Bankart plus remplissage restored stiffness equal to the intact model unlike Bankart repair alone in cadavers with concurrent Bankart and Hill-Sachs defects. The same results of improved stiffness and stability with loss of external rotation in the cadaveric model were found by Giles et al 20 and Elkinson et al 21 The clinical studies measuring range of motion, however, have not demonstrated this to be a significant problem.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic Remplissage for Moderate-Size Hill-Sachs Lesion

Alexander

Beicker

Tokish

2016

Arthroscopy Techniques

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Humeral bone loss has been shown to be a risk factor for failure after arthroscopic treatment of instability. We present the arthroscopic remplissage technique originally described by Koo and Burkhart et al. with a modification in the percutaneous anchor placement and suture tying that is reproducible and effective. We percutaneously place 2 suture anchors, which require no additional suture passing across the tissue, to create a double pulley technique, filling the defect with posterior capsule and rotator cuff. Therefore, the Hill-Sachs defect becomes extra-articular, eliminating the potential engagement of the anterior glenoid and contribution to recurrence of instability. This technique is applicable broadly for most Hill-Sachs lesions that need addressing. By not having to pass or shuttle any suture through tissue after anchor placement and by eliminating the necessity to go subacromially to retrieve or tie suture, the technique saves time and improves reproducibility. The compression of tissue into the Hill Sachs surface area also is improved by double-reinforced suturing through the double-pulley technique. The combination of these advantages creates a sound and efficient technique for remplissage.

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Bankart repair versus Bankart repair plus remplissage: an in vitro biomechanical comparative study

Abstract: In cadaveric shoulders with combined Bankart and Hill-Sachs lesions, Bankart lesion repair associated with remplissage restored intact joint stiffness contrary to Bankart lesion repair alone. This increase in stiffness was associated with a decrease in external rotation.

Cited by 39 publications

References 38 publications

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

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

Arthroscopic Double-Pulley Remplissage Using a 2-Portal Technique for Hill-Sachs Lesions in Recurrent Anterior Shoulder Instability

Arthroscopic Remplissage for Moderate-Size Hill-Sachs Lesion

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