Long-term outcomes of arthroscopic Bankart repair and Hill-Sachs remplissage for bipolar bone defects.

Autor: Martinez-Catalan N; Paris Shoulder Unit, Institut de La Main Clinique Bizet, 21 bis rue Georges Bizet, 75116, Paris, France. natalia.martinezcat@gmail.com.; Hospital Fundación Jiménez Diaz, Avenida de los Reyes Católicos 2, 28040, Madrid, Spain. natalia.martinezcat@gmail.com., Kazum E; Division of Orthopaedic Surgery, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel., Zampeli F; Hand-Upper Limb-Microsurgery Department, General Hospital KAT, Athens, Greece., Cartaya M; Shoulder Surgery, Hospital del Trabajador de Santiago, Ramón Carnicer 185, Providencia, Región Metropolitana, Chile., Cerlier A; CMCO Centre Méditerranéen De Chirurgie Orthopédique, 189 ter Av. François Mitterrand, 13170, Les Pennes-Mirabeau, France., Valenti P; Paris Shoulder Unit, Institut de La Main Clinique Bizet, 21 bis rue Georges Bizet, 75116, Paris, France.
Jazyk: angličtina
Zdroj: European journal of orthopaedic surgery & traumatology : orthopedie traumatologie [Eur J Orthop Surg Traumatol] 2023 May; Vol. 33 (4), pp. 947-953. Date of Electronic Publication: 2022 Feb 28.
DOI: 10.1007/s00590-022-03237-8
Abstrakt: Purpose: To evaluate long-term results after arthroscopic Bankart repair and Hill-Sachs remplissage (BHSR) in bipolar bone defects with less than 20% of glenoid bone loss (GBL) and to analyse risk factors for recurrent dislocation.
Methods: From 2009-2012, 43 patients with recurrent anterior shoulder instability were treated with BHSR. Inclusion criteria were GBL < 20% and minimum of 4-yearfollow-up. There were 35 males and 8 females with a mean age of 29 years (range 16-53). The mean ISIS score was 3.6 (range 2-6). Patients were evaluated for recurrence, range of motion and functional outcomes (Walch-Duplay and Rowe score). Post-operative MRI was performed at least 6 months after surgery to evaluate infraspinatus capsulotenodesis healing. Glenoid track was assessed retrospectively from pre-operative computed tomography. Mean follow-up was 7.3 years (range 4-11).
Results: At the last follow-up, good to excellent outcomes were reported in 86% of patients. Average post-operative Walch-Duplay was 87.9 (range 75-100) and ROWE 93.7 (range 70-100). Infraspinatus capsulotenodesis healing was achieved in 86%. The rate of recurrence and revision surgery was 9.3% and 13.9%, respectively. Recurrence was associated with higher ISIS score (p = 0.0191) and lower age at surgery (p = 0.0227). Four (9.3%) Hill-Sachs lesions were considered off-track. The presence of off-track Hill-Sachs was associated with higher risk of recurrence (p < 0.00001).
Conclusion: Arthroscopic BHSR improves shoulder instability in the setting of bipolar bone defects with less than 20% of GBL. Patient-related factors and pre-operative glenoid track should be taken into consideration to reduce the risk of recurrence.
(© 2022. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.)
Databáze: MEDLINE
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