Skip to main content
SpringerLink
Log in

Management of an engaging Hill–Sachs lesion: arthroscopic remplissage with Bankart repair versus Latarjet procedure

  • Shoulder
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

This study compared the clinical outcomes of arthroscopic remplissage with Bankart repair and Latarjet operation in patients with a large engaging Hill–Sachs lesion.

Methods

Thirty-seven shoulders subjected to arthroscopic remplissage with a Bankart repair (group A) and 35 shoulders subjected to a Latarjet operation (group B), for a large engaging Hill–Sachs lesion without significant glenoid bone loss, were retrospectively evaluated. Each group was followed up for a mean more than 2-year period.

Results

At the last follow-up, postoperative pain, shoulder mobility, muscle strength, Rowe score, and UCLA score revealed no significant difference between the two groups. The postoperative mean deficit in external rotation at the side (ERs) was 8° ± 23° in group A (P = 0.044). In group B, the mean deficits in ERs, external rotation at 90° of abduction, and internal rotation to the posterior were 10° ± 20°, 7° ± 16°, and 1.9° ± 4°, respectively (P = 0.004, 0.022, and 0.009, respectively). The recurrence rate was 5.4 % (two shoulders) in group A and 5.7 % (two shoulders) in group B (n.s.). The overall complication rate was significantly higher in group B (14.3 %) than in group A (0 %) (P = 0.017).

Conclusions

For recurrent anterior shoulder instability with a large engaging Hill–Sachs lesion, both arthroscopic remplissage with Bankart repair and the Latarjet procedure were safe and reliable techniques with a low recurrence rate. However, the Latarjet group had a significantly higher postoperative complication rate than the remplissage group.

Level of evidence

Case–control study, Level III.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Allain J, Goutallier D, Glorion C (1998) Long-term results of the Latarjet procedure for the treatment of anterior instability of the shoulder. J Bone Joint Surg Am 80:841–852

    Article  CAS  PubMed  Google Scholar 

  2. Armitage MS, Faber KJ, Drosdowech DS, Litchfield RB, Athwal GS (2010) Humeral head bone defects: remplissage, allograft, and arthroplasty. Orthop Clin N Am 41:417–425

    Article  Google Scholar 

  3. Balg F, Boileau P (2007) The instability severity index score. A simple pre-operative score to select patients for arthroscopic or open shoulder stabilisation. J Bone Joint Surg Br 89:1470–1477

    Article  CAS  PubMed  Google Scholar 

  4. Boileau P, O’Shea K, Vargas P, Pinedo M, Old J, Zumstein M (2012) Anatomical and functional results after arthroscopic Hill–Sachs remplissage. J Bone Joint Surg Am 94:618–626

    Article  PubMed  Google Scholar 

  5. Burkhart SS, De Beer JF (2000) Traumatic glenohumeral bone defects and their relationship to failure of arthroscopic Bankart repairs: significance of the inverted-pear glenoid and the humeral engaging Hill–Sachs lesion. Arthroscopy 16:677–694

    Article  CAS  PubMed  Google Scholar 

  6. Burkhart SS, De Beer JF, Barth JR, Cresswell T, Roberts C, Richards DP (2007) Results of modified Latarjet reconstruction in patients with anteroinferior instability and significant bone loss. Arthroscopy 23:1033–1041

    Article  PubMed  Google Scholar 

  7. Calandra JJ, Baker CL, Uribe J (1989) The incidence of Hill–Sachs lesions in initial anterior shoulder dislocations. Arthroscopy 5:254–257

    Article  CAS  PubMed  Google Scholar 

  8. Chapovsky F, Kelly JD 4th (2005) Osteochondral allograft transplantation for treatment of glenohumeral instability. Arthroscopy 21:1007

    Article  PubMed  Google Scholar 

  9. Chuang TY, Adams CR, Burkhart SS (2008) Use of preoperative three-dimensional computed tomography to quantify glenoid bone loss in shoulder instability. Arthroscopy 24:376–382

    Article  PubMed  Google Scholar 

  10. Degen RM, Giles JW, Johnson JA, Athwal GS (2014) Remplissage versus latarjet for engaging Hill–Sachs defects without substantial glenoid bone loss: a biomechanical comparison. Clin Orthop Relat Res 472:2363–2371

    Article  PubMed  PubMed Central  Google Scholar 

  11. Dines JS, Dodson CC, McGarry MH, Oh JH, Altchek DW, Lee TQ (2013) Contribution of osseous and muscular stabilizing effects with the Latarjet procedure for anterior instability without glenoid bone loss. J Shoulder Elbow Surg 22:1689–1694

    Article  PubMed  Google Scholar 

  12. Ellman H, Hanker G, Bayer M (1986) Repair of the rotator cuff. End-result study of factors influencing reconstruction. J Bone Joint Surg Am 68:1136–1144

    Article  CAS  PubMed  Google Scholar 

  13. Gordins V, Hovelius L, Sandström B, Rahme H, Bergström U (2015) Risk of arthropathy after the Bristow-Latarjet repair: a radiologic and clinical thirty-three to thirty-five years of follow-up of thirty-one shoulders. J Shoulder Elbow Surg 24:691–699

    Article  PubMed  Google Scholar 

  14. Grondin P, Leith J (2009) Case series: combined large Hill–Sachs and bony Bankart lesions treated by Latarjet and partial humeral head resurfacing: a report of 2 cases. Can J Surg 52:249–254

    PubMed  PubMed Central  Google Scholar 

  15. Hovelius L, Vikerfors O, Olofsson A, Svensson O, Rahme H (2011) Bristow-Latarjet and Bankart: a comparative study of shoulder stabilization in 185 shoulders during a seventeen-year follow-up. J Shoulder Elbow Surg 20:1095–1101

    Article  PubMed  Google Scholar 

  16. Huysmans PE, Haen PS, Kidd M, Dhert WJ, Willems JW (2006) The shape of the inferior part of the glenoid: a cadaveric study. J Shoulder Elbow Surg 15:759–763

    Article  PubMed  Google Scholar 

  17. Koo SS, Burkhart SS, Ochoa E (2009) Arthroscopic double-pulley remplissage technique for engaging Hill–Sachs lesions in anterior shoulder instability repairs. Arthroscopy 25:1343–1348

    Article  PubMed  Google Scholar 

  18. Kronberg M, Brostrom LA (1995) Rotation osteotomy of the proximal humerus to stabilise the shoulder. Five years’ experience. J Bone Joint Surg Br 77:924–927

    Article  CAS  PubMed  Google Scholar 

  19. Kropf EJ, Sekiya JK (2007) Osteoarticular allograft transplantation for large humeral head defects in glenohumeral instability. Arthroscopy 23:322.e1-5

  20. Latarjet M (1954) Treatment of recurrent dislocation of the shoulder. Lyon Chir 49:994–997

    CAS  PubMed  Google Scholar 

  21. Leroux T, Bhatti A, Khoshbin A, Wasserstein D, Henry P, Marks P, Takhar K, Veillette C, Theodoropolous J, Chahal J (2013) Combined arthroscopic Bankart repair and remplissage for recurrent shoulder instability. Arthroscopy 29:1693–1701

    Article  PubMed  Google Scholar 

  22. Longo UG, Loppini M, Rizzello G, Ciuffreda M, Maffulli N, Denaro V (2014) Latarjet, Bristow, and Eden-Hybinette procedures for anterior shoulder dislocation: systematic review and quantitative synthesis of the literature. Arthroscopy 30:1184–1211

    Article  PubMed  Google Scholar 

  23. Lynch JR, Clinton JM, Dewing CB, Warme WJ, Matsen FA 3rd (2009) Treatment of osseous defects associated with anterior shoulder instability. J Shoulder Elbow Surg 18:317–328

    Article  PubMed  Google Scholar 

  24. Merolla G, Paladini P, Di Napoli G, Campi F, Porcellini G (2015) Outcomes of arthroscopic Hill–Sachs remplissage and anterior Bankart repair: a retrospective controlled study including ultrasound evaluation of posterior capsulotenodesis and infraspinatus strength assessment. Am J Sports Med 43:407–414

    Article  PubMed  Google Scholar 

  25. Mizuno N, Denard PJ, Raiss P, Melis B, Walch G (2014) Long-term results of the Latarjet procedure for anterior instability of the shoulder. J Shoulder Elbow Surg 23:1691–1699

    Article  PubMed  Google Scholar 

  26. Ochoa E Jr, Burkhart SS (2009) Glenohumeral bone defects in the treatment of anterior shoulder instability. Instr Course Lect 58:323–336

    PubMed  Google Scholar 

  27. Paladini P, Merolla G, De Santis E, Campi F, Porcellini G (2012) Long-term subscapularis strength assessment after Bristow-Latarjet procedure: isometric study. J Shoulder Elbow Surg 21:42–47

    Article  PubMed  Google Scholar 

  28. Park MJ, Tjoumakaris FP, Garcia G, Patel A, Kelly JDt JDT (2011) Arthroscopic remplissage with Bankart repair for the treatment of glenohumeral instability with Hill–Sachs defects. Arthroscopy 27:1187–1194

    Article  PubMed  Google Scholar 

  29. Picard F, Saragaglia D, Montbarbon E, Tourne Y, Thony F, Charbel A (1998) Anatomo-clinical consequences of the vertical sectioning of the subscapular muscle in Latarjet intervention. Rev Chir Orthop Reparatrice Appar Mot 84:217–223

    CAS  PubMed  Google Scholar 

  30. Purchase RJ, Wolf EM, Hobgood ER, Pollock ME, Smalley CC (2008) Hill–Sachs “remplissage”: an arthroscopic solution for the engaging Hill–Sachs lesion. Arthroscopy 24:723–726

    Article  PubMed  Google Scholar 

  31. Re P, Gallo RA, Richmond JC (2006) Transhumeral head plasty for large Hill–Sachs lesions. Arthroscopy 22:798.e1–798.e4

  32. Rhee YG, Cho NS, Yoo JH, Lee WG (2015) Filling index score of remplissage (FISOR): a useful measurement tool to evaluate structural outcome after remplissage. J Shoulder Elbow Surg 24:613–620

    Article  PubMed  Google Scholar 

  33. Rowe CR, Patel D, Southmayd WW (1978) The Bankart procedure: a long-term end-result study. J Bone Joint Surg Am 60:1–16

    Article  CAS  PubMed  Google Scholar 

  34. Scheibel M, Habermeyer P (2008) Subscapularis dysfunction following anterior surgical approaches to the shoulder. J Shoulder Elbow Surg 17:671–683

    Article  PubMed  Google Scholar 

  35. Scheibel M, Kraus N, Diederichs G, Haas NP (2008) Arthroscopic reconstruction of chronic anteroinferior glenoid defect using an autologous tricortical iliac crest bone grafting technique. Arch Orthop Trauma Surg 128:1295–1300

    Article  PubMed  Google Scholar 

  36. Schmid SL, Farshad M, Catanzaro S, Gerber C (2012) The Latarjet procedure for the treatment of recurrence of anterior instability of the shoulder after operative repair: a retrospective case series of forty-nine consecutive patients. J Bone Joint Surg Am 94:e75

    Article  PubMed  Google Scholar 

  37. Shah AA, Butler RB, Romanowski J, Goel D, Karadagli D, Warner JJ (2012) Short-term complications of the Latarjet procedure. J Bone Joint Surg Am 94:495–501

    Article  PubMed  Google Scholar 

  38. Streubel PN, Krych AJ, Simone JP, Dahm DL, Sperling JW, Steinmann SP, O’Driscoll SW, Sanchez-Sotelo J (2014) Anterior glenohumeral instability: a pathology-based surgical treatment strategy. J Am Acad Orthop Surg 22:283–294

    Article  PubMed  Google Scholar 

  39. Sugaya H, Kon Y, Tsuchiya A (2005) Arthroscopic repair of glenoid fractures using suture anchors. Arthroscopy 21:635

    PubMed  Google Scholar 

  40. Voos JE, Livermore RW, Feeley BT, Altchek DW, Williams RJ, Warren RF, Cordasco FA, Allen AA (2010) Prospective evaluation of arthroscopic bankart repairs for anterior instability. Am J Sports Med 38:302–307

    Article  PubMed  Google Scholar 

  41. Weber BG, Simpson LA, Hardegger F (1984) Rotational humeral osteotomy for recurrent anterior dislocation of the shoulder associated with a large Hill–Sachs lesion. J Bone Joint Surg Am 66:1443–1450

    Article  CAS  PubMed  Google Scholar 

  42. Yamamoto N, Muraki T, An KN, Sperling JW, Cofield RH, Itoi E, Walch G, Steinmann SP (2013) The stabilizing mechanism of the Latarjet procedure: a cadaveric study. J Bone Joint Surg Am 95:1390–1397

    Article  PubMed  Google Scholar 

  43. Young AA, Maia R, Berhouet J, Walch G (2011) Open Latarjet procedure for management of bone loss in anterior instability of the glenohumeral joint. J Shoulder Elbow Surg 20:S61–S69

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This research was supported by sports scientification of Convergent R&D Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning (NRF-2014M3C1B1033319).

Author information

Authors and Affiliations

  1. Shoulder and Elbow Clinic, Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University, 1 Hoegi-dong, Dongdaemun-gu, Seoul, 130-702, Korea

    Nam Su Cho, Jae Hyun Yoo & Yong Girl Rhee

Authors
  1. Nam Su Cho
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jae Hyun Yoo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yong Girl Rhee
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yong Girl Rhee.

Additional information

This study is retrospective in nature and final approval of exemption by the Institutional Review Board was obtained (IRB Approval No.: KHNMC IRB 2012-135).

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Cho, N.S., Yoo, J.H. & Rhee, Y.G. Management of an engaging Hill–Sachs lesion: arthroscopic remplissage with Bankart repair versus Latarjet procedure. Knee Surg Sports Traumatol Arthrosc 24, 3793–3800 (2016). https://doi.org/10.1007/s00167-015-3666-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00167-015-3666-9

Keywords

Search

Navigation