Abstract: Purpose: For anterior shoulder instability with off-track Hill-Sachs lesion (HSL) and subcritical loss of glenoid bone (less than 20%), Bankart repair and Remplissage (BRR) has been recommended. The goal of this work was to assess the functional outcomes following BRR among individuals with anterior shoulder instability and off-track HSL with loss of glenoid bone of less than 20%.
Methods: BRR was used to manage 41 individuals who had anterior shoulder instability with off-track HSL and loss of glenoid bone under 20%. They were monitored for a median of 23 months after surgery. The Western Ontario Shoulder Instability Index (WOSI) and the American Shoulder & Elbow Surgeons score (ASES) were used to evaluate the functional result. The shoulder range of motion including external rotation at the side (ERs), forward flexion (FF), internal rotation in abduction (IRa) and external rotation in abduction (ERa), was recorded.
Results: The postoperative ASES and WOSI scores for each participant significantly improved when compared to their preoperative values, with a mean difference of 46.1%±19.5 and 29.2±13.3 correspondingly. The mean decrease in ERa, ERs, FF, and IRa were (13.09%±8.2), (22.5%±16.18), (2.46%±1.92), and (10.12%±6) respectively. There was no correlation between functional scores and limitation of ER.
Conclusion: In anterior shoulder instability patients with loss of glenoid bone of less than 20% and off-track HSL, combined arthroscopic Bankart repair and remplissage results in satisfactory functional outcomes. Over the duration of the trial, the rate of recurrence was 2.5 percent. There was a statistically significant limitation of range of motion of shoulder mainly in external rotation. However, this was functionally insignificant.
Level of evidence: Therapeutic Level IV, case series study
