Midterm outcomes of arthroscopic remplissage for the management of recurrent anterior shoulder instability.
OBJECTIVE
The purpose of the study was to present midterm results concerning the management of recurrent anterior shoulder instability with the remplissage technique in addition to the classic Bankart repair, in patients with engaging Hill-Sachs lesions.


METHODS
During a time period of 4 years (January 2007-December 2010), 48 patients with an average age of 28.9 ± 7.8 years were operated on in our department. They all had a positive apprehension sign pre-operatively and satisfied the inclusion criteria of this study. Seventy-nine per cent of these patients were involved in sport activities of different levels. The mean follow-up period was 37.2 ± 9.9 months.


RESULTS
Three patients (6.3 %) had suffered a new dislocation: one of them after a low-energy trauma and the two other after a high-energy trauma. The rest of the patients (93.7 %) were satisfied with the surgical result and returned to their previous everyday activities while 70.8 % continued to participate in sporting activities without restrictions. The ASES score increased from 67.7 ± 21.5 points pre-operatively to 90.8 ± 21.7 points post-operatively (p < 0.01), the modified Rowe score from 38 ± 17.3 to 93.8 ± 14.5 (p < 0.001) and the Oxford Instability score from 27.6 ± 11.1 to 45.1 ± 8.3 (p < 0.001). No significant restriction in shoulder range of motion was documented.


CONCLUSIONS
The outcome of the enhancement of the classic Bankart repair with tenodesis of the infraspinatus and posterior capsular plication is very good as far as the management of recurrent anterior shoulder instability is concerned, without significantly influencing the range of motion of the shoulder.


METHODS
Therapeutic study-case series with no comparison group, Level IV.
2nd Orthopaedic Department, Shoulder Arthroscopy and Surgery Center, IASO General Hospital, 44-46 Str. Sevastopoulou, 115 24, Athens, Greece. emmanuel.brilakis@gmail.com.
Emmanouil
E
Brilakis
2nd Orthopaedic Department, Shoulder Arthroscopy and Surgery Center, IASO General Hospital, 44-46 Str. Sevastopoulou, 115 24, Athens, Greece. eliasmataragas@gmail.com.
Elias
E
Mataragas
2nd Orthopaedic Department, Shoulder Arthroscopy and Surgery Center, IASO General Hospital, 44-46 Str. Sevastopoulou, 115 24, Athens, Greece. delitasos@hotmail.com.
Anastasios
A
Deligeorgis
Department of Radiology, IASO General Hospital, Athens, Greece. vmaniatis67@gmail.com.
Vasilios
V
Maniatis
2nd Orthopaedic Department, Shoulder Arthroscopy and Surgery Center, IASO General Hospital, 44-46 Str. Sevastopoulou, 115 24, Athens, Greece. manosanton@gmail.com.
Emmanouil
E
Antonogiannakis
D000328:Adult; D001182:Arthroscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017746:Joint Capsule / Q000601:surgery; D007593:Joint Instability / Q000601:surgery*; D008297:Male; D012008:Recurrence; D012189:Retrospective Studies; D012783:Shoulder Dislocation / Q000601:surgery*; D012785:Shoulder Joint / Q000601:surgery*; D013709:Tendon Transfer; D013710:Tendons / Q000601:surgery; D053656:Tenodesis; D016896:Treatment Outcome; D055815:Young Adult
Arthroscopy; Engaging Hill–Sachs lesion; Recurrent anterior shoulder instability; Remplissage; Shoulder