title: Bankart repair versus Bankart repair plus remplissage: an in vitro biomechanical comparative study.
abstract: OBJECTIVE
  To biomechanically compare Bankart lesion repair alone and Bankart lesion repair associated with infraspinatus capsulotenodesis described as «remplissage», in the treatment of combined Bankart and Hill-Sachs lesions.
  
  
  METHODS
  Seven pairs (right and left) of cadaveric shoulders have been tested, first without any lesion and then after performing a combined Bankart and Hill-Sachs lesions. For each pair, the specimens were then randomly assigned for Bankart lesion repair alone on one side or for Bankart lesion repair associated with remplissage on the other side. During tests, the shoulder was placed at 90° of abduction and at maximal external rotation, which value was recorded. A 50 N postero-anterior load was then applied to the proximal humerus, and the stiffness was calculated from the obtained load-displacement curve.
  
  
  RESULTS
  Bankart and Hill-Sachs lesions significantly (p < 0.05) decreased joint stiffness compared with intact joint. Bankart lesion repair alone did not restore stiffness to the level of intact, while adding the remplissage to the Bankart lesion repair did. External rotation was significantly increased after creation of the Bankart and Hill-Sachs lesion; Bankart repair restored the external rotation to the level of intact, while Bankart lesion repair associated with remplissage significantly decreased external rotation compared with intact and to Bankart lesion repair alone.
  
  
  CONCLUSIONS
  In cadaveric shoulders with combined Bankart and Hill-Sachs lesions, Bankart lesion repair associated with remplissage restored intact joint stiffness contrary to Bankart lesion repair alone. This increase in stiffness was associated with a decrease in external rotation.
authors.affiliation: Institut de Recherche en Chirurgie Orthopédique et Sportive (IRCOS), 6 Avenue Alphonse XIII, 75016, Paris, France. j.grimberg@lircos.org.
authors.forename: Jean
authors.initials: J
authors.lastname: Grimberg
authors.affiliation: Equipe Biomécanique et Remodelage Osseux (EPBRO), Arts et Métiers ParisTech, 151 Boulevard de l'Hôpital, 75013, Paris, France.
authors.forename: Amadou
authors.initials: A
authors.lastname: Diop
authors.forename: Rony
authors.initials: R
authors.lastname: Bou Ghosn
authors.affiliation: Institut de Recherche en Chirurgie Orthopédique et Sportive (IRCOS), 6 Avenue Alphonse XIII, 75016, Paris, France.
authors.forename: Rosny Bou
authors.initials: RB
authors.lastname: Ghosn
authors.affiliation: Equipe Biomécanique et Remodelage Osseux (EPBRO), Arts et Métiers ParisTech, 151 Boulevard de l'Hôpital, 75013, Paris, France.
authors.forename: Dimitri
authors.initials: D
authors.lastname: Lanari
authors.affiliation: Equipe Biomécanique et Remodelage Osseux (EPBRO), Arts et Métiers ParisTech, 151 Boulevard de l'Hôpital, 75013, Paris, France.
authors.forename: Adrien
authors.initials: A
authors.lastname: Canonne
authors.affiliation: Equipe Biomécanique et Remodelage Osseux (EPBRO), Arts et Métiers ParisTech, 151 Boulevard de l'Hôpital, 75013, Paris, France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Maurel
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001182:Arthroscopy / Q000379:methods*; D001696:Biomechanical Phenomena; D002102:Cadaver; D005260:Female; D006801:Humans; D017746:Joint Capsule / Q000293:injuries / Q000601:surgery; D007593:Joint Instability / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D016059:Range of Motion, Articular; D017006:Rotator Cuff / Q000503:physiopathology / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D012783:Shoulder Dislocation / Q000503:physiopathology / Q000601:surgery*; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000503:physiopathology / Q000601:surgery*; D053441:Suture Anchors; D013708:Tendon Injuries / Q000601:surgery*; D053656:Tenodesis
keywords: Bankart lesion; Hill-Sachs lesion; In vitro biomechanical study; Remplissage; Shoulder instability