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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.
MedLine Citation:
PMID:  21505080     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Engaging Hill-Sachs lesions are known to be a risk factor for recurrence dislocation after arthroscopic repair in patients with anterior shoulder instability. For a large engaging Hill-Sachs lesion, arthroscopic remplissage is a solution. HYPOTHESIS: Arthroscopic Bankart repair combined with the Hill-Sachs remplissage technique can achieve good results without significant impairment of shoulder function. STUDY DESIGN: Case Series; Level of evidence, 4. METHODS: Forty-nine consecutive patients who underwent arthroscopic Bankart repair and Hill-Sachs remplissage for anterior shoulder instability were followed up for a mean duration of 29.0 months (range, 24-35 months). There were 42 males and 7 females with a mean age of 28.4 years (range, 16.7-54.7 years). All patients had diagnosed traumatic unidirectional anterior shoulder instability with a bony lesion of glenoid and an engaging Hill-Sachs lesion. Physical examination, radiographs, and magnetic resonance imaging were performed during postoperative follow-up. The American Shoulder and Elbow Surgeons (ASES) score, Constant score, and Rowe score were used to evaluate shoulder function. RESULTS: The active forward elevation increased a mean of 8.0° (range, -10° to 80°) postoperatively. However, the patients lost 1.9° (range, -40° to 30°) of external rotation to the side. Significant improvement was detected with regard to the ASES score (84.7 vs 96.0, P < .001), Constant score (93.3 vs 97.8, P = .005), and Rowe score (36.8 vs 89.8, P < .001). There were 1 redislocation, 2 subluxations, and 1 patient with a positive apprehension test; the overall failure rate was 8.2% (4 of 49). Successful healing of the infraspinatus tendon within the Hill-Sachs lesion was shown by magnetic resonance imaging. CONCLUSION: Arthroscopic Bankart repair combined with Hill-Sachs remplissage can restore shoulder stability without significant impairment of shoulder function in patients with engaging Hill-Sachs lesions.
Authors:
Yi-Ming Zhu; Yi Lu; Jin Zhang; Jie-Wei Shen; Chun-Yan Jiang
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-4-19
Journal Detail:
Title:  The American journal of sports medicine     Volume:  -     ISSN:  1552-3365     ISO Abbreviation:  -     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-4-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7609541     Medline TA:  Am J Sports Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Sports Medicine Department, Beijing Ji Shui Tan Hospital, Beijing, People's Republic of China.
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