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International Orthopaedics
Published in: International Orthopaedics 12/2017

01-12-2017 | Original Paper

Results of arthroscopic Bankart repair with Hill-Sachs remplissage for anterior shoulder instability

Authors: Nicolas Bonnevialle, Vadim Azoulay, Amélie Faraud, Fanny Elia, Pascal Swider, Pierre Mansat

Published in: International Orthopaedics | Issue 12/2017

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Abstract

Purpose

The aim of this study was to evaluate mid-term outcomes of Bankart repair with Hill-Sachs remplissage (BHSR) and to highlight prognostic factors of failure.

Methods

Thirty-four patients operated on for anterior shoulder instability with BHSR were enrolled in a prospective non-randomised study. Clinical and radiographic evaluation was performed at 1.5, three, six months and yearly thereafter. Outcome measures included Rowe and Walch-Duplay score.

Results

At mean follow-up of 35 months (24–63), the Rowe and Walch-Duplay scores reached respectively 92.7 and 88.2 points. The mean deficit in external rotation was 6° in ER1 and 1° in ER2 (p = 0.4, p = 0.9 respectively). Five patients (14.7%) had a recurrence of instability and three others had a persistent anterior apprehension. In the failure group, the Hill-Sachs lesion was deeper (26% vs 19% of the humeral diameter; p = 0.04) and range of motion at 1.5 months postoperatively was greater. Age at surgery, pre-operative instability severity index score (ISIS), hyperlaxity, type and level of sport, amount of glenoid bone loss had no correlation with failure rate.

Conclusions

The rate of failure at mid-term follow-up of BHSR was higher than commonly reported. The premature recovery of range of motion seems to be a clinical sign of failure at follow-up. Moreover, in case of deep Hill-Sachs lesion (>20%) an alternative procedure should be considered.

Level of evidence

Level IV.
Appendix
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Metadata
Title
Results of arthroscopic Bankart repair with Hill-Sachs remplissage for anterior shoulder instability
Authors
Nicolas Bonnevialle
Vadim Azoulay
Amélie Faraud
Fanny Elia
Pascal Swider
Pierre Mansat
Publication date
01-12-2017
Publisher
Springer Berlin Heidelberg
Published in
International Orthopaedics / Issue 12/2017
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-017-3491-5

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