Off-track Hill–Sachs lesions do not increase postoperative recurrent instability after arthroscopic Bankart repair with selective Remplissage procedure

In Park, Jun Seok Kang, Yoon Geol Jo, Sang Woo Kim, Sang Jin Shin

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

Purpose: This study aimed to compare clinical outcomes and recurrence rates after arthroscopic Bankart repair with selective Remplissage procedure, between patients with off-track and on-track Hill–Sachs lesions. Methods: Patients who underwent arthroscopic Bankart repair with selective Remplissage procedure for recurrent anterior shoulder instability and were followed up for at least 2 years were included. Patients with a glenoid defect greater than 25% were excluded. According to the glenoid track concept, patients were divided into group I (off-track lesions) and group II (on-track lesions). After Bankart repair, an additional Remplissage procedure was performed selectively in patients who sustained engagement of the humeral head. The clinical outcomes and recurrence rates were evaluated. Results: A total of 193 patients (23 in group I and 170 in group II) were enrolled. No significant differences were found in clinical outcomes (n.s.) or recurrence rates (n.s.) between the two groups, despite larger glenoid defects in group I (group I:17.1 ± 6.1%, and group II:13.0 ± 6.4%, P = 0.003). In all patients, the incidence of off-track lesions was not significantly different according to the occurrence of postoperative recurrence (n.s.), whereas the glenoid defect size showed a significant difference (with recurrence: 17.9 ± 3.9%, and without recurrence: 13.2 ± 6.5%, P = 0.002). Conclusions: The presence of an off-track lesion did not alter the clinical outcomes and recurrence rates after arthroscopic Bankart repair with selective Remplissage procedure. The glenoid defect size rather than the presence of an off-track lesion can more reliably predict postoperative recurrence. Arthroscopic Bankart repair with selective Remplissage procedure is considered one surgical option for the treatment of off-track lesions. Level of evidence: III.

Original languageEnglish
Pages (from-to)3864-3870
Number of pages7
JournalKnee Surgery, Sports Traumatology, Arthroscopy
Volume27
Issue number12
DOIs
StatePublished - 1 Dec 2019

Keywords

  • Arthroscopy
  • Bipolar
  • Bone defect
  • Glenoid track
  • Recurrent instability
  • Shoulder

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