title: Arthroscopic remplissage with Bankart repair for the treatment of glenohumeral instability with Hill-Sachs defects.
abstract: OBJECTIVE
  To determine whether arthroscopic remplissage with Bankart repair is an effective treatment strategy for patients with Bankart lesions and large Hill-Sachs defects.
  
  
  METHODS
  Between 2006 and 2008, 20 patients underwent arthroscopic Bankart repair with remplissage for the treatment of recurrent anterior glenohumeral instability and large Hill-Sachs defects. Preoperative imaging in all patients identified avulsion of the anterior inferior glenohumeral ligament with an associated Hill-Sachs defect that involved greater than 25% of the humeral head. Patients were followed up postoperatively with the Western Ontario Shoulder Instability score, the American Shoulder and Elbow Surgeons score, and the Penn Shoulder Score. Recurrent subluxation or dislocation was documented.
  
  
  RESULTS
  There were 15 male patients and 5 female patients. The mean age of the patients was 27.3 years. The mean length of follow-up in this series was 29.2 months (range, 24.3 to 37.7 months). At final follow-up, 3 patients reported recurrence of instability, which spontaneously reduced in all cases. The mean American Shoulder and Elbow Surgeons score was 92.5 (pain, 47.3; function, 45.3). The mean Penn score was 90 of 100 (pain, 27.3 of 30; satisfaction, 8.5 of 10; function, 54.3 of 60). The mean total Western Ontario Shoulder Instability score was 72.74% (mean physical symptom score, 77.10%; mean sports and recreation score, 70.25%; mean lifestyle score, 75%; mean emotions score, 58.50%).
  
  
  CONCLUSIONS
  Using an all-arthroscopic remplissage technique with Bankart repair, we were able to restore function, diminish pain, and yield satisfaction in 85% of the patients in this study. Our results compare favorably with historic controls with similar pathology at early- to intermediate-term follow-up in terms of recurrence.
  
  
  METHODS
  Level IV, therapeutic case series.
authors.affiliation: Department of Orthopaedics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Min Jung
authors.initials: MJ
authors.lastname: Park
authors.forename: Fotios P
authors.initials: FP
authors.lastname: Tjoumakaris
authors.forename: Grant
authors.initials: G
authors.lastname: Garcia
authors.forename: Amit
authors.initials: A
authors.lastname: Patel
authors.forename: John D
authors.initials: JD
authors.lastname: Kelly
mesh_terms: D000328:Adult; D000368:Aged; D001182:Arthroscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006811:Humerus / Q000293:injuries / Q000601:surgery*; D007593:Joint Instability / Q000601:surgery*; D008023:Ligaments, Articular / Q000293:injuries / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012008:Recurrence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012783:Shoulder Dislocation / Q000150:complications; D012784:Shoulder Fractures / Q000209:etiology / Q000601:surgery*; D012785:Shoulder Joint / Q000601:surgery*; D020069:Shoulder Pain / Q000209:etiology / Q000601:surgery; D013536:Suture Techniques; D055815:Young Adult