scholarly journals Clinical Outcome of Arthroscopic Remplissage as Augmentation During Arthroscopic Bankart Repair for Recurrent Anterior Shoulder Instability

2017 ◽  
Vol 11 (1) ◽  
pp. 1268-1276 ◽  
Author(s):  
Ryosuke Miyamoto ◽  
Atsushi Yamamoto ◽  
Hitoshi Shitara ◽  
Tsuyoshi Ichinose ◽  
Daisuke Shimoyama ◽  
...  
Keyword(s):  
Los Angeles ◽  
Bone Defect ◽  
External Rotation ◽  
Bankart Repair ◽  
Anterior Shoulder Instability ◽  
Control Group ◽  
Arthroscopic Bankart Repair ◽  
Clinical Scores ◽  
Bony Bankart ◽  
One Year

Purpose:We aimed to assess functional outcomes and postoperative recurrence rate associated with the remplissage procedure used for bone augmentation with Bankart repair in patients with Hill-Sachs lesions after shoulder dislocation.Methods:Preoperative computed tomography was performed to check for bony Bankart lesions,calculate the bone defect rate, and estimate the risk for re-dislocation. Functional and clinical scores were assessed preoperatively and at three months, six months, and one year postoperatively.Results:Between 2011 and 2014, 18 patients (17 male; age at surgery, 29.0±10.4 years; 18 affected shoulders) underwent arthroscopic Bankart repair with arthroscopic remplissage (remplissage group), and 18 sex- and age-matched controls underwent arthroscopic Bankart repair alone (control group). The incidence of bony Bankart lesion and glenoid bone defect was significantly higher in the remplissage group. No complications, re-dislocation, or re-subluxation was noted during or after the operation. Postoperatively, the range of motion and muscular weakness alleviated with time, and the clinical scores improved significantly from the preoperative values. However, the remplissage group showed significantly restricted shoulder flexion, abduction, internal rotation and external rotation even at one year postoperatively. Compared to the control group, the remplissage group showed significantly lower Rowe scores preoperatively, and both Rowe scores and University of California-Los Angeles scale scores remained significantly lower throughout the one-year follow-up.Conclusion:Despite some restriction of external rotation, remplissage leads to better clinical scores and no recurrence, providing a valid means of augmentation for Bankart repair in high-risk patients with engaged Hill-Sachs lesion.

Borderline Glenoid Bone Defect in Anterior Shoulder Instability: Latarjet Procedure Versus Bankart Repair

2018 ◽  
Vol 46 (9) ◽  
pp. 2170-2176 ◽  
Author(s):  
Yoon Sang Jeon ◽  
Ho Yeon Jeong ◽  
Dong Ki Lee ◽  
Yong Girl Rhee
Keyword(s):  
Bone Defect ◽  
Shoulder Instability ◽  
External Rotation ◽  
Bankart Repair ◽  
Anterior Shoulder Instability ◽  
Latarjet Procedure ◽  
Spinal Segment ◽  
Arthroscopic Bankart Repair ◽  
Recurrent Anterior Shoulder Instability

Background: The optimal procedure for anterior shoulder instability with a borderline (15%-20%) bone defect on the anterior rim of the glenoid is still controversial. Purpose: To compare the clinical outcome and recurrence rate between the arthroscopic Bankart repair and Latarjet procedure among patients with recurrent anterior shoulder instability and a borderline glenoid bone defect. Study Design: Cohort study; Level of evidence, 3. Methods: The authors retrospectively reviewed cases of arthroscopic Bankart repair and the Latarjet procedure for recurrent anterior shoulder instability with a borderline (15%-20%) glenoid bone defect. Enrollment comprised 149 patients (Bankart group, n = 118; Latarjet group, n = 31). The mean follow-up and age at operation were 28.9 ± 7.3 months (range, 24-73 months) and 26 ± 5 years (range, 16-46 years), respectively. Results: Rowe and UCLA (University of California, Los Angeles) shoulder scores significantly improved from 42.0 ± 14.3 and 22.9 ± 3.2 preoperatively to 90.9 ± 15.4 and 32.5 ± 3.3 postoperatively in the Bankart group ( P < .001) and from 41.0 ± 17.9 and 22.3 ± 3.4 to 91.1 ± 16.1 and 32.3 ± 3.4 in the Latarjet group ( P < .001), respectively. There were no significant between-group differences in Rowe ( P = .920) or UCLA ( P = .715) scores at the final follow-up. Mean postoperative loss of motion during forward flexion, external rotation in abduction, and internal rotation to the posterior was 3.0° ± 6.2°, 11.6° ± 10.2°, and 0.6 spinal segment in the Bankart group and 3.7° ± 9.8°, 10.3° ± 12.8°, and 0.9 spinal segment in the Latarjet group, respectively. These differences were not significant. However, the loss of external rotation at the side was significantly greater in the Bankart group (13.3° ± 12.9°) than in the Latarjet group (7.3° ± 18.1°, P = .034). The overall recurrence rate was significantly higher in the Bankart group (22.9%) than in the Latarjet group (6.5%), ( P = .040). Conclusion: The Latarjet procedure and arthroscopic Bankart repair both provided satisfactory clinical outcome scores and pain relief for anterior shoulder instability with a borderline glenoid bone defect. However, the Latarjet procedure resulted in significantly lower recurrences and less external rotation limitation than the arthroscopic Bankart repair. Therefore, the Latarjet procedure could be a more reliable surgical option in anterior recurrent instability with a borderline glenoid bone defect.

scholarly journals Revision Arthroscopic Bankart Repair Versus Arthroscopic Latarjet for Failed Primary Arthroscopic Stabilization With Subcritical Bone Loss

2021 ◽  
Vol 9 (5) ◽  
pp. 232596712110018
Author(s):  
Emilio Calvo ◽  
Gonzalo Luengo ◽  
Diana Morcillo ◽  
Antonio M. Foruria ◽  
María Valencia
Keyword(s):  
Soft Tissue ◽  
Bone Loss ◽  
Revision Surgery ◽  
Shoulder Instability ◽  
Activity Level ◽  
Bankart Repair ◽  
Anterior Shoulder Instability ◽  
Arthroscopic Bankart Repair ◽  
Functional Scores ◽  
Arthroscopic Latarjet

Background: Limited evidence is available regarding the recommended technique of revision surgery for recurrent shoulder instability. Only 1 previous study has compared the results of soft tissue repair and the Latarjet technique in patients with persistent shoulder instability after primary surgical stabilization. Purpose/Hypothesis: To evaluate the results of revision surgery in patients with previous surgical stabilization failure and subcritical glenoid bone defects, comparing repeated Bankart repair versus arthroscopic Latarjet technique. The hypothesis was that Latarjet would be superior to soft tissue procedures in terms of objective and subjective functional scores, recurrence rates, and range of movement. Study Design: Cohort study; Level of evidence, 3. Methods: Included were 45 patients (mean age, 29.1 ± 8.9 years) with subcritical bone loss (<15% of articular surface) who had undergone revision anterior shoulder instability repair after failed Bankart repair. Of these, 17 patients had arthroscopic Bankart repair and 28 had arthroscopic Latarjet surgery. Patients were evaluated at a minimum of 2 years postoperatively with the Rowe score, Western Ontario Shoulder Instability Index, and Subjective Shoulder Value. Subluxation or dislocation episodes were considered failures. Results: No statistically significant differences were found between groups in age, sex, sporting activity, preoperative Rowe score, or the presence of hyperlaxity or bony lesions. At revision arthroscopy, 20 shoulders showed a persistent Bankart lesion, 13 a medially healed labrum, and 6 a bony Bankart. In 6 patients, no abnormalities were present that could explain postoperative recurrence. In the Bankart repair group, 7 patients underwent isolated Bankart procedures; in the remaining 10 cases, a capsular shift was added. No significant differences were found between the Bankart and Latarjet groups in outcome scores, recurrence rate (11.8% vs 17.9%, respectively), or postoperative athletic activity level. The mean loss of passive external rotation at 0° and 90° of abduction was similar between groups. Conclusion: Arthroscopic Latarjet did not lead to superior results compared with repeated Bankart repair in patients with subcritical glenoid bone loss and recurrent anterior shoulder instability after Bankart repair.

The playing position significantly influences return to sports and recurrences after an arthroscopic Bankart repair in competitive rugby players

2021 ◽  
pp. 175857322199308
Author(s):  
Ignacio Pasqualini ◽  
Luciano Andrés Rossi ◽  
Franco Luis De Cicco ◽  
Ignacio Tanoira ◽  
Ignacio Alonso Hidalgo ◽  
...  
Keyword(s):  
Shoulder Instability ◽  
Functional Outcomes ◽  
The Other ◽  
Bankart Repair ◽  
Anterior Shoulder Instability ◽  
Return To Sports ◽  
Arthroscopic Bankart Repair ◽  
Rugby Players

Background The purpose of our study was to investigate the influence of the different rugby playing positions on return to sports, functional outcomes, and recurrences after an arthroscopic Bankart repair. Methods A total of 88 rugby players were treated for anterior shoulder instability in our institution between 2010 and 2018. Functional outcomes, return to sports, recurrences, complications, and revisions rates were evaluated according to the playing position. Results Overall, 73.8% of the patients returned to rugby and 60% returned at the same level as before the injury. The tight forwards and outside backs experienced a significant decrease in their competitive level after surgery, and showed the lowest functional outcomes. The tight forwards and outside backs showed a statistically significant increase in recurrence and revision rates, and an OR for recurrence of 12.8 and 9.6, respectively. Discussion The playing position significantly influenced return to sports and recurrences after an arthroscopic Bankart repair in competitive rugby players. Specifically, the tight forwards and outside backs have returned to a lower level than they had before surgery, showed the lowest functional outcomes, and a significant increase in recurrences and revisions rates than the other groups.

scholarly journals Treatment of anterior shoulder instability: a bibliometric analysis

2022 ◽  
Vol 17 (1) ◽  
Author(s):  
Mingtao Zhang ◽  
Zhitao Yang ◽  
Borong Zhang ◽  
Tao Liu ◽  
Xiangdong Yun
Keyword(s):  
United States ◽  
Risk Factors ◽  
Shoulder Instability ◽  
Sports Medicine ◽  
The United States ◽  
Bankart Repair ◽  
Anterior Shoulder Instability ◽  
Arthroscopic Bankart Repair ◽  
Number Of Citations ◽  
Research Frontiers

Abstract Purpose The treatment of anterior shoulder instability is a focus in the field of sports medicine. While much research has been conducted, few bibliometric studies have been performed in this field. This study analyzed the main characteristics and identified emerging research trends and hotspots related to the treatment of anterior shoulder instability over the past four decades. Methods We searched for (anterior shoulder instability OR anterior shoulder dislocation) AND (treatment OR reconstruction) in ARTICLE (Mesh) in the Web of Science database from 1980 to 2020. We analyzed the keywords, author, institution, country, number of citations, average number of citations, publication year, and partnership of the identified articles. Information about annual publications was analyzed using Microsoft Excel 2019; the remaining data were analyzed using VOSviewer version 1.6.11 (Leiden University, Leiden, Netherlands) and CiteSpace version 5.7.R2 (Drexel University, Philadelphia, PA, USA). Results A total of 1964 articles were published between 1980 and 2020. The American Journal of Sports Medicine, the United States, the United States Department of Defense, and Arcieio were journals, countries, institutions, and authors with the highest numbers of publications. The topic hotspots were instability, shoulder, and dislocation, while the research frontiers were arthroscopic, Bankart repair, Latarjet procedure, risk factors, recurrence, and complications. Conclusion The treatment of anterior shoulder instability has shown an increasing number of publications each year and achieved great progress. The United States made the most outstanding contributions to this important field. Arthroscopic, Bankart repair, and Latarjet procedures were research hotspots and risk factors, recurrence, and complications were likely to research frontiers.

scholarly journals Comparison of clinical and patient-reported outcomes of three procedures for recurrent anterior shoulder instability: arthroscopic Bankart repair, capsular shift, and open Latarjet

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Yingjie Xu ◽  
Kailun Wu ◽  
Qianli Ma ◽  
Lei Zhang ◽  
Yong Zhang ◽  
...  
Keyword(s):  
Shoulder Instability ◽  
Bankart Repair ◽  
Anterior Shoulder Instability ◽  
Subjective Perception ◽  
Capsular Shift ◽  
Shift Group ◽  
Arthroscopic Bankart Repair ◽  
Significant Difference ◽  
Patient Reported ◽  
Recurrent Anterior Shoulder Instability

Abstract Background Best surgical of recurrent anterior shoulder instability remained controversial. We knew little about the superiority and choice between traditional open and modern arthroscopic techniques. We hypothesized that outcomes of all patients will be similar regardless of surgical technique. Methods A retrospective case-cohort analysis of 168 patients who had recurrent anterior shoulder instability was conducted from September 2010 to December 2013. All cases (mean age 30.8 [range 18–50] years) were performed with arthroscopic Bankart repair (33 males/20 females), open Latarjet (34 males/18 females), and capsular shift (31 males/14 females). The average follow-up was 67.6 months (range 60–72). The shoulder instability index score (ISIS) was more than 3 with an average of 6.4. Results All treatments proved to be effective in improving shoulder functional status and reducing symptoms, while Latarjet had an advantage over subjective perception. The Rowe scores in arthroscopic Bankart, open Latarjet, and capsular shift group were 92.3 ± 1.5, 96.2 ± 2.1, and 93.2 ± 2.3, respectively, with significant difference. There was no significant difference in other functional outcomes. However, the Latarjet group in subjective results (subjective shoulder value (SSV) and subjective shoulder value for sport practice (SSV Sport)) was superior to the others (P < 0.05). There were two relapsed cases in arthroscopic Bankart and capsular shift group, respectively, and no recurrence in open Latarjet group. Conclusion Arthroscopic Bankart repair has the advantage of mini-invasion and rapid recovery. Capsular shift offers stabilizing of inferior or multidirectional type, especially for little bone defect. Latarjet was more effective in reducing recurrence with higher stability. Level of evidence Therapeutic level III

scholarly journals Arthroscopic Bankart repair with knotless suture anchors: A comparison of the permanent and absorbable types

2020 ◽  
Vol 27 (2) ◽  
pp. 202-207
Author(s):  
Abdulrahman D Algarni
Keyword(s):  
External Rotation ◽  
Shoulder Function ◽  
Bankart Repair ◽  
Suture Anchors ◽  
Glenohumeral Instability ◽  
Arthroscopic Bankart Repair ◽  
Significant Difference ◽  
Functional Scores ◽  
Group 2 ◽  
Group 1

Aim: The aim of this study was to compare the clinical outcomes of arthroscopic Bankart repair (ABR) using two types of knotless suture anchors (KSAs) in patients with post-traumatic recurrent anterior glenohumeral instability (AGHI). Methods: Thirty-two patients underwent an ABR using KSAs: a permanent KSA (PushLock) and an absorbable counterpart (BioKnotless). There were 16 patients in each group. Pre-and post-operative assessment for shoulder function using the American Shoulder and Elbow Surgeons and Constant–Murley scores, recurrence of instability, post-operative limitation of external rotation (ER) and ability to return to pre-injury level were recorded in both groups. Results: Both groups displayed significant improvements in functional scores ( p < 0.0001) without a significant difference between the groups. Of the 32 patients, 9.4% had recurrence of instability (one re-dislocation in group 1 and two symptomatic subluxations in group 2). Return to pre-injury level occurred in 87.5% and 81.3% of group 1 and group 2, respectively. There was 2° to 3° loss of ER after ABR in both groups; the difference between the groups was not significant ( p = 0.45). Conclusion: ABR for recurrent AGHI using a permanent or absorbable KSA offers comparable successful outcomes; no significant statistical difference was found.

scholarly journals Double-Row Repair Technique Provides Improved Dynamic Stabilization over Single-Row Repairs for Acute Bony Bankart Lesions

2019 ◽  
Vol 7 (7_suppl5) ◽  
pp. 2325967119S0043
Author(s):  
Alexander Greenstein ◽  
Alexander M. Brown ◽  
Aaron Roberts ◽  
Raymond Edward Chen ◽  
Emma Knapp ◽  
...  
Keyword(s):  
External Rotation ◽  
Bankart Repair ◽  
Fixation Technique ◽  
Double Row ◽  
Single Row ◽  
Bony Bankart Lesion ◽  
Bony Bankart ◽  
Double Row Repair ◽  
Cadaveric Model ◽  
Bankart Lesions

Objectives: Previous studies of bony Bankart repair comparing single- and double-row reconstruction techniques have examined static forces required to displace the bony Bankart lesion. No studies, to date, have examined stability of bony Bankart repair with more physiologic concavity-compression model. We hypothesize the double-row fixation technique would provide superior stability and decreased displacement of a simulated bony Bankart lesion in a concavity-compression cadaveric model compared with single-row technique.Our aim was to examine the dynamic stability and ultimate displacement of single- vs double-row repair techniques for acute bony Bankart lesions Methods: Testing was performed on 13 matched pairs of glenoids with simulated bony Bankart fractures with a defect width of 25% of the glenoid diameter. Half of the fractures were repaired with a double-row technique, while the contralateral glenoids were repaired with a single-row technique. To determine dynamic biomechanical stability and ultimate step-off of the repairs a 150 N load and 2000 cycles of internal-external rotation at 1 Hz was applied to specimens to simulate standard rehabilitation protocols. Toggle was quantified throughout cycling with a coordinate measuring machine. After cyclic loading, the fracture displacement was measured. 3D spatial measurements were calculated using MATLAB. Results: The double-row technique resulted in significantly (p=0.005) less displacement (mean=342.48 µm SD=300.64 µm) than single-row technique (mean=981.84 µm, SD=640.38 µm). Ultimate fracture displacement of double-row repair was significantly less (mean=792.23 µm, SD=333.85 µm, p=0.046) after simulated rehabilitation by internal-external rotation cycling compared to single-row repair (mean=1,267.38 µm, SD=640.38 µm). Conclusion: The double-row fixation technique for arthroscopic bony Bankart repair results in superior stability throughout simulated rehabilitation and decreases ultimate displacement in a concavity-compression cadaveric model.

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