2017 ISAKOS Biennial Congress ePoster #2035

 

Bankart Repair And Remplissage For On-Track Hill-Sachs Lesion In Collision Athletes

Peter Domos, MD, FRCS(Tr&Orth), London UNITED KINGDOM
Andrew L Wallace, MD, PhD, FRCS, FRACS, London UNITED KINGDOM

Hospital of St John and St Elizabeth and Fortius Clinic, London, London, UNITED KINGDOM

FDA Status Not Applicable

Summary

Arthroscopic remplissage with Bankart repair is an effective treatment to improve outcomes for high-risk collision athletes.

ePosters will be available shortly before Congress

Abstract

Purpose

The aim of this study was to determine whether arthroscopic remplissage with Bankart repair is an effective treatment to improve outcomes for collision athletes with Bankart and non-engaging/on-track Hill-Sachs lesions.

Methods

All patients had traumatic unidirectional anterior shoulder instability with Bankart and non-engaging Hill-Sachs lesions, but without substantial glenoid bone loss. 20 collision athletes underwent arthroscopic Bankart repair with posterior capsulodesis (B&R group) and were evaluated retrospectively, using pre- and postoperative WOSI, EQ-5D, EQ-VAS scores and postoperative Subjective Shoulder Value (SSV). The recurrence and reoperation rates, return to play (RTP) were compared to a matched group of 20 collision athletes, with isolated arthroscopic Bankart repair (B group).

Results

The mean age was 25 years old (15-40), with an average follow up of 26 months. The mean WOSI, EQ-5D and EQ-VAS scores improved from 41.7% to 86.5%, 0.75 to 0.92 and 72.7 to 84.5, respectively, with SSV of 90%. There was a mean deficit in external rotation at the side of 10° (5-15°). 5 patients had initial weakness but no final decrease in muscle strength. 5 patients had initial stiffness but only 1 had residual mild stiffness. Another patient was treated with hydrodilatation for frozen shoulder. 1 patient had residual posterior discomfort but no apprehension in the B&R group, compared with 5% persistent apprehension in the B group. In comparison, the recurrence and reoperation rates were 5% and 30% (p=0.015), 5% and 35% (p=0.005) in the B&R and B groups, respectively. RTP averaged 13 weeks in both groups.

Conclusion

This combined technique demonstrated good outcomes, with lower recurrence rates. The slight restriction in ER does not significantly affect any clinical outcomes and RTP. This method may be considered as alternative reconstruction technique in high-risk collision athletes.