title: The Influence of Arthroscopic Remplissage for Engaging Hill-Sachs Lesions Combined with Bankart Repair on Redislocation and Shoulder Function Compared with Bankart Repair Alone.
abstract: BACKGROUND
  Recurrence of glenohumeral dislocation after arthroscopic Bankart repair can be associated with a large osseous defect in the posterosuperior part of the humeral head. Our hypothesis is that remplissage is more effective to prevent recurrence of glenohumeral instability without a severe motion deficit.
  
  
  METHODS
  Engaging Hill-Sachs lesions were observed in 48 of 737 patients (6.5%). Twenty-four patients underwent arthroscopic Bankart repair combined with remplissage (group I) and the other 24 patients underwent arthroscopic Bankart repair alone (group II). Clinical outcomes were prospectively evaluated by assessing the range of motion. Complications, recurrence rates, and functional results were assessed utilizing the American Shoulder and Elbow Surgeons (ASES) score, Rowe score, and the Korean Shoulder Score for Instability (KSSI) score. Capsulotenodesis healing after remplissage was evaluated with magnetic resonance imaging.
  
  
  RESULTS
  The average ASES, Rowe, and KSSI scores were statistically significantly higher in group I than group II. The frequency of recurrence was statistically significantly higher in group II. The average loss in external rotation measured with the arm positioned at the side of the trunk was greater in group II and that in abduction was also higher in group II.
  
  
  CONCLUSIONS
  Compared to single arthroscopic Bankart repair, the remplissage procedure combined with arthroscopic Bankart repair was more effective to prevent the recurrence of anterior shoulder instability without significant impact on shoulder mobility in patients who had huge Hill-Sachs lesions.
authors.affiliation: Department of Orthopedic Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
authors.forename: Sang-Hun
authors.initials: SH
authors.lastname: Ko
authors.affiliation: Department of Orthopedic Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
authors.forename: Jae-Ryong
authors.initials: JR
authors.lastname: Cha
authors.affiliation: Department of Orthopedic Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
authors.forename: Chae-Chil
authors.initials: CC
authors.lastname: Lee
authors.affiliation: Department of Orthopedic Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
authors.forename: Il-Yeong
authors.initials: IY
authors.lastname: Hwang
authors.affiliation: Department of Orthopedic Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
authors.forename: Chang-Gyu
authors.initials: CG
authors.lastname: Choe
authors.affiliation: Department of Orthopedic Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
authors.forename: Min-Seok
authors.initials: MS
authors.lastname: Kim
mesh_terms: D000328:Adult; D001182:Arthroscopy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D019637:Orthopedic Procedures / Q000379:methods* / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012008:Recurrence; D012782:Shoulder / Q000601:surgery*; D012783:Shoulder Dislocation / Q000601:surgery*; D055815:Young Adult
keywords: Bankart lesions; Hill-Sachs lesion; Joint instability; Prospective study; Remplissage; Shoulder dislocation