Document Detail

Comparison of arthroscopic osteochondral substitute grafting and remplissage for engaging hill-sachs lesions.
MedLine Citation:
PMID:  23276350     Owner:  NLM     Status:  In-Data-Review    
The optimum management for recurrent glenohumeral instability with significant humeral head defects remains controversial. The purpose of this study was to compare outcomes and recurrence rates between patients who underwent osteochondral substitute grafting and patients who underwent remplissage to treat recurrent shoulder instability from an engaging Hill-Sachs defect with a Bankart lesion.Twenty consecutive patients who underwent remplissage and 19 consecutive patients who underwent osteochondral substitute grafting with Bankart repair were studied. Mean follow-up was 29.6 months for the remplissage group and 32.1 months for the osteochondral substitute grafting group. All patients had an engaging Hill-Sachs lesion, and indications for surgery were identical between groups. Three postoperative recurrences occurred in the remplissage group and 6 occurred in the osteochondral substitute grafting group (P=.18). Nineteen patients in the remplissage group and 7 patients in the osteochondral substitute grafting group had a large humeral head defect. Patients in the remplissage group had better Western Ontario Shoulder Instability Index [WOSI] scores than those in the osteochondral substitute grafting group for large lesions (74.7 vs 50.4, respectively), although they were not statistically significant (P=.077). After controlling for age, sex, lesion size, and follow-up differences, the remplissage group reported significantly better WOSI scores (P=.016).This study demonstrated a potential advantage of remplissage compared with osteochondral synthetic grafting in patients who experienced recurrent anterior shoulder instability, particularly in shoulders with a large humeral head defect.
Grant H Garcia; Min Jung Park; Keith Baldwin; John Fowler; John D Kelly; Fotios P Tjoumakaris
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Orthopedics     Volume:  36     ISSN:  1938-2367     ISO Abbreviation:  Orthopedics     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-01-01     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7806107     Medline TA:  Orthopedics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e38-43     Citation Subset:  IM    
Copyright Information:
Copyright 2013, SLACK Incorporated.
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