Clinical and functional outcomes of the remplissage technique to repair anterior shoulder dislocation: average 7 years of follow-up

Bitar, Alexandre Carneiro; Fabiani, M. C.; Ferrari, Denise; Garofo, Antônio Guilherme Padovani; Schor, Breno; Zorzenoni, Fernando Ometto; Nico, Marcelo Astolfi Caetano; Scalize, Antonio Rodolpho Hakime; Castropil, Wagner

doi:10.1007/s12306-019-00630-1

Cited by 7 publications

(3 citation statements)

References 43 publications

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“…The mean time to redislocation was 2.2 years (1.8-2.8 years). Bitar et al 3 showed a recurrence rate of 9.5% in their series of 21 patients (mean age, 27.8 years) with a mean follow-up of approximately 7 years (range, 28-126 months). Cavalier et al 7 divided patients in their study into minimal (<10%) or subcritical (10%-20%) glenoid bone loss.…”

Section: Discussionmentioning

confidence: 93%

“…21 The key finding of the study was that the rate of postoperative recurrent instability was significantly reduced in patients undergoing arthroscopic Bankart repair with remplissage compared with those who underwent isolated arthroscopic Bankart repair at 24 months postoperative. In addition, no differences were found in any subjective outcomes at any time point (3,6,12, and 24 months postoperative), specifically, the Western Ontario Shoulder Instability score, the American Shoulder and Elbow score, or the Simple Shoulder Test. The purpose of the present study was to compare the medium-term outcomes of the patients randomized to isolated arthroscopic Bankart repair (NO REMP) or Bankart repair with remplissage (REMP) in the previous study.…”

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confidence: 88%

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Arthroscopic Bankart Repair With Remplissage in Anterior Shoulder Instability Results in Fewer Redislocations Than Bankart Repair Alone at Medium-term Follow-up of a Randomized Controlled Trial

Woodmass,

McRae,

Lapner

et al. 2024

Am J Sports Med

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Background: A multicenter, double-blinded randomized controlled trial comparing isolated Bankart repair (NO REMP) to Bankart repair with remplissage (REMP) reported benefits of remplissage in reducing recurrent instability at 2 years postoperative. The ongoing benefits beyond this time point are yet to be explored. Purpose: To (1) compare medium-term (3 to 9 years) outcomes of these previously randomized patients undergoing isolated Bankart repair (NO REMP) or Bankart repair with remplissage (REMP) to manage recurrent anterior glenohumeral instability; (2) examine the failure rate, overall recurrent instability, and reoperation rate. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: Recruitment and randomization for the original randomized trial occurred between 2011 and 2017. Patients ≥14 years diagnosed with recurrent traumatic anterior shoulder instability with an engaging Hill-Sachs defect of any size were included. Those with a glenoid defect >15% were excluded. In 2020, participants were contacted by telephone and asked standardized questions regarding ensuing instances of subluxation, dislocation, or reoperation on their study shoulder. “Failure” was defined as a redislocation, and “overall recurrent instability” was described as a redislocation or ≥2 subluxations. Descriptive statistics, relative risk, and Kaplan-Meier survival curve analyses were performed. Results: A total of 108 participants were randomized, of whom 50 in the NO REMP group and 52 in the REMP group were included in the analyses in the original study. The mean number of months from surgery to the final follow-up was 49.3 and 53.8 months for the NO REMP and REMP groups, respectively. Failure rates were 22% (11/50) in the NO REMP group versus 8% (4/52) in the REMP group. Rates of overall recurrent instability were 30% (15/50) in the NO REMP group versus 10% (5/52) in the REMP group. Survival curves were significantly different, favoring REMP in both scenarios. Conclusion: For the treatment of traumatic recurrent anterior shoulder instability with a Hill-Sachs lesion and subcritical glenoid bone loss (<15%), a significantly lower rate of overall postoperative recurrent instability was observed with arthroscopic Bankart repair and remplissage than with isolated Bankart repair at a medium-term follow-up (mean of 4 years). Patients who did not receive a remplissage experienced a failure (redislocated) earlier and had a higher rate of revision/reoperation than those who received a concomitant remplissage. Registration: NCT01324531 (ClinicalTrials.gov identifier).

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Section: Discussionmentioning

confidence: 93%

mentioning

confidence: 88%

Arthroscopic Bankart Repair With Remplissage in Anterior Shoulder Instability Results in Fewer Redislocations Than Bankart Repair Alone at Medium-term Follow-up of a Randomized Controlled Trial

Woodmass,

McRae,

Lapner

et al. 2024

Am J Sports Med

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“… 20 Remplissage is becoming increasingly popular as an adjunct to both arthroscopic Bankart repair and bone augmentation procedures, but there remains concern in some studies regarding lower rates of return to sport at the same level in patients and external rotation stiffness risks after remplissage. 5 , 9 Open bone block procedures, including Bristow, Latarjet, distal clavicle autograft, and distal tibia allograft, among others, also carry well-known associated complications, including neurological injury, screw prominence, osteolysis, and nonunion, among others. 13 , 27 As arthroscopic bone block procedures continue to advance, they may become more desirable as they provide bony augmentation while minimizing the risk of neurovascular injuries and preserving the subscapularis.…”

Section: Discussionmentioning

confidence: 99%

Recurrent Instability After Arthroscopic Bankart Repair in Patients With Hyperlaxity and Near-Track Lesions

Boden,

Charles,

Hughes

et al. 2023

Orthopaedic Journal of Sports Medicine

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Background: Recurrent anterior shoulder instability after arthroscopic Bankart repair presents a challenging clinical problem, with the primary stabilization procedure often portending the best chance for clinical success. Purpose: To determine if capsuloligamentous laxity affects failure (recurrent dislocation, subluxation, and/or perceived instability symptoms) after arthroscopic Bankart repair in patients with near-track lesions (ie, those with smaller distance to dislocation [DTD]). Study Design: Case-control study; Level of evidence, 3. Methods: The authors retrospectively reviewed consecutive patients who underwent primary arthroscopic Bankart repair for recurrent anterior glenohumeral instability at a single institution between 2007 and 2019 and who had at least 2 years of follow-up data. Patients with glenoid bone loss >20%, off-track lesions, concomitant remplissage, or rotator cuff tear were excluded. Capsuloligamentous laxity, or hyperlaxity, was defined as external rotation >85° with the arm at the side and/or grade ≥2 in at least 2 planes with the shoulder at 90° of abduction. Near-track lesions were defined as those with a DTD <10 mm. Results: Included were 173 patients (mean age, 20.5 years; mean DTD, 16.2 mm), of whom 16.8% sustained a recurrent dislocation and 6.4% had recurrent subluxations (defined as any subjective complaint of recurrent instability without frank dislocation), for an overall recurrent instability rate of 23.1%. The rate of revision stabilization was 15.6%. The mean time to follow-up was 7.4 years. Independent predictors of recurrent instability were younger age ( P = .001), smaller DTD ( P = .021), >1 preoperative instability episode ( P < .001), and the presence of hyperlaxity during examination under anesthesia ( P = .013). Among patients with near-track lesions, those with hyperlaxity had a recurrent instability rate almost double that of patients without hyperlaxity (odds ratio, 34.1; P = .04). The increased rate of failure and recurrent dislocation in the near-track hyperlaxity cohort remained elevated, even in patients with no bone loss. Conclusion: Capsuloligamentous shoulder laxity was a significant independent risk factor for failure after primary arthroscopic Bankart repair without remplissage and was more predictive of failure in patients with versus without near-track lesions.

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Return to Sport After Arthroscopic Bankart Repair With Remplissage: A Systematic Review

Gouveia

Harbour

Athwal

et al. 2023

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Clinical and functional outcomes of the remplissage technique to repair anterior shoulder dislocation: average 7 years of follow-up

Cited by 7 publications

References 43 publications

Arthroscopic Bankart Repair With Remplissage in Anterior Shoulder Instability Results in Fewer Redislocations Than Bankart Repair Alone at Medium-term Follow-up of a Randomized Controlled Trial

Arthroscopic Bankart Repair With Remplissage in Anterior Shoulder Instability Results in Fewer Redislocations Than Bankart Repair Alone at Medium-term Follow-up of a Randomized Controlled Trial

Recurrent Instability After Arthroscopic Bankart Repair in Patients With Hyperlaxity and Near-Track Lesions

Return to Sport After Arthroscopic Bankart Repair With Remplissage: A Systematic Review

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