title: Anterior shoulder instability with engaging Hill-Sachs defects: a comparison of arthroscopic Bankart repair with and without posterior capsulodesis.
abstract: OBJECTIVE
  The purpose of this study was to compare the clinical results of isolated arthroscopic Bankart repair and those of arthroscopic Bankart repair with posterior capsulodesis for anterior shoulder instability with engaging Hill-Sachs lesions.
  
  
  METHODS
  Thirty-five shoulders that underwent isolated arthroscopic Bankart repair (Bankart group) and 37 shoulders that underwent arthroscopic Bankart repair with posterior capsulodesis (remplissage group) for anterior shoulder instability with engaging Hill-Sachs lesions were evaluated retrospectively. The mean age at the time of the surgery was 26.1 ± 7.0 years in the Bankart group and 24.8 ± 9.0 years in the remplissage group.
  
  
  RESULTS
  At the final follow-up, the Rowe and UCLA scores significantly improved in both the Bankart and remplissage groups (P < 0.001, in both groups). The post-operative mean deficit in external rotation at the side was 3° ± 10° in the Bankart group and 8° ± 23° in the remplissage group (P = n.s. and P = 0.044, respectively). There was no decrease in muscle strength in either group. The recurrence rate was 25.7 % in the Bankart group and 5.4 % in the remplissage group (P = 0.022).
  
  
  CONCLUSIONS
  Arthroscopic Bankart repair with posterior capsulodesis demonstrated good clinical outcomes with a low recurrence rate in the treatment for anterior shoulder instability with an engaging Hill-Sachs lesion. Although a limitation in external rotation was observed, there was no significant limitation of any other motion and no decrease in muscle strength after the remplissage procedure. Posterior capsulodesis alone for remplissage should be considered as a surgical technique that can replace the conventional method.
  
  
  METHODS
  Case-control study, Level III.
authors.affiliation: Shoulder and Elbow Clinic, Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University, 1 Hoegi-dong, Dongdaemun-gu, Seoul, 130-702, Korea.
authors.forename: Nam Su
authors.initials: NS
authors.lastname: Cho
authors.affiliation: Shoulder and Elbow Clinic, Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University, 1 Hoegi-dong, Dongdaemun-gu, Seoul, 130-702, Korea.
authors.forename: Jae Hyun
authors.initials: JH
authors.lastname: Yoo
authors.affiliation: Shoulder and Elbow Clinic, Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University, 1 Hoegi-dong, Dongdaemun-gu, Seoul, 130-702, Korea.
authors.forename: Hyung Suk
authors.initials: HS
authors.lastname: Juh
authors.affiliation: Shoulder and Elbow Clinic, Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University, 1 Hoegi-dong, Dongdaemun-gu, Seoul, 130-702, Korea. shoulderrhee@hanmail.net.
authors.forename: Yong Girl
authors.initials: YG
authors.lastname: Rhee
mesh_terms: D000293:Adolescent; D000328:Adult; D000671:Amputation, Surgical; D001178:Arthroplasty; D001182:Arthroscopy / Q000379:methods*; D000070896:Bankart Lesions / Q000601:surgery*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D016059:Range of Motion, Articular / Q000502:physiology; D012008:Recurrence; D012189:Retrospective Studies; D012399:Rotation; D012782:Shoulder / Q000601:surgery; D012783:Shoulder Dislocation / Q000601:surgery; D012785:Shoulder Joint / Q000601:surgery*; D055815:Young Adult
keywords: Anterior instability; Arthroscopic Bankart repair; Engaging; Hill–Sachs lesion; Posterior capsulodesis; Remplissage; Shoulder