title: Rotator interval closure has no additional effect on shoulder stability compared to Bankart repair alone.
abstract: OBJECTIVE
  Arthroscopic Bankart repair (ABR) provides satisfactory results for recurrent anterior shoulder instability, but the high recurrence rate post-ABR remain a concern. One of the adjunct procedures proposed to improve ABR results is arthroscopic rotator interval closure (ARIC). This study prospectively evaluated the outcomes of ABRs alone compared to combined ABR + ARIC and identified risk factors related to failure of each procedure.
  
  
  METHODS
  Thirty-nine consecutive patients (mean age 23.1 (18.3-37.5) years; 37 males) underwent arthroscopic stabilization for recurrent anterior traumatic shoulder instability. Twenty patients underwent ABR alone and 19 underwent ABR + ARIC. Remplissage was added when glenoid engagement was observed during surgery. All patients were prospectively followed, and their postoperative courses were reviewed and functionally assessed at the last visit.
  
  
  RESULTS
  The re-dislocation rate was higher in the ABR + ARIC group compared to the ABR only group at a mean follow-up of 4.2 (2-5.6) years (3 vs. 0, P = 0.06). More subluxations were found in the ABR only group (2 vs. 1, respectively; P = 0.58). The final limitation of range of motion (ROM) compared with the preoperative ROM was similar in both groups. Remplissage procedures were performed more often in the ABR only group [12 (60%) vs. 4 (21%), P = 0.013].
  
  
  CONCLUSIONS
  ARIC performed as an adjunct to ABR showed no superiority in attaining value-added stability compared to ABR alone. Adding a remplissage procedure may achieve better stability.
  
  
  METHODS
  Level 2.
authors.affiliation: Shoulder Unit, Division of Orthopaedic Surgery, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, 6 Weizman Street, Tel Aviv, 64239, Israel.
authors.forename: Eran
authors.initials: E
authors.lastname: Maman
authors.affiliation: Shoulder Unit, Division of Orthopaedic Surgery, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, 6 Weizman Street, Tel Aviv, 64239, Israel. dolkarto@gmail.com.
authors.forename: Oleg
authors.initials: O
authors.lastname: Dolkart
authors.affiliation: Shoulder Unit, Division of Orthopaedic Surgery, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, 6 Weizman Street, Tel Aviv, 64239, Israel.
authors.forename: Efi
authors.initials: E
authors.lastname: Kazum
authors.affiliation: Shoulder Unit, Division of Orthopaedic Surgery, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, 6 Weizman Street, Tel Aviv, 64239, Israel.
authors.forename: Noam
authors.initials: N
authors.lastname: Rosen
authors.affiliation: Shoulder Unit, Division of Orthopaedic Surgery, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, 6 Weizman Street, Tel Aviv, 64239, Israel.
authors.forename: Gavriel
authors.initials: G
authors.lastname: Mozes
authors.affiliation: Shoulder Unit, Division of Orthopaedic Surgery, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, 6 Weizman Street, Tel Aviv, 64239, Israel.
authors.forename: Michael
authors.initials: M
authors.lastname: Drexler
authors.affiliation: Shoulder Unit, Division of Orthopaedic Surgery, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, 6 Weizman Street, Tel Aviv, 64239, Israel.
authors.forename: Ofir
authors.initials: O
authors.lastname: Chechik
mesh_terms: D000328:Adult; D001178:Arthroplasty / Q000009:adverse effects / Q000379:methods; D001182:Arthroscopy / Q000009:adverse effects / Q000379:methods; D005260:Female; D006801:Humans; D007557:Israel; D007593:Joint Instability / Q000601:surgery*; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D011446:Prospective Studies; D016059:Range of Motion, Articular; D012008:Recurrence; D012307:Risk Factors; D012783:Shoulder Dislocation / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D012785:Shoulder Joint / Q000503:physiopathology / Q000601:surgery
keywords: Arthroscopy; Bankart repair; Hyperlaxity; Remplissage; Rotator interval; Shoulder dislocation