TY - JOUR
T1 - Remplissage With Bankart Repair in Anterior Shoulder Instability
T2 - A Systematic Review of the Clinical and Cadaveric Literature
AU - Alkaduhimi, Hassanin
AU - Verweij, Lukas P.E.
AU - Willigenburg, Nienke W.
AU - van Deurzen, Derek F.P.
AU - van den Bekerom, Michel P.J.
PY - 2019/4
Y1 - 2019/4
N2 - Purpose: To compare the clinical and biomechanical results of an arthroscopic Bankart repair alone with an arthroscopic Bankart repair combined with remplissage. Methods: A literature search was performed on May 1, 2018, in PubMed and Embase for studies comparing an isolated arthroscopic Bankart repair and an arthroscopic Bankart repair with remplissage. The quality of the studies was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach and the Cochrane Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) checklist. Results regarding failures, biomechanical properties, and shoulder function were extracted. Results: We included 13 studies (6 clinical and 7 biomechanical studies), and their overall quality was very low to low. In the biomechanical studies, adding a remplissage to the Bankart repair prevented engagement in all cadavers, resulted in more stiffness, and impaired the range of motion. Among clinical studies, all reported lower recurrence rates and most showed better shoulder function after a Bankart repair with remplissage compared with an isolated Bankart repair. The return-to-sport rates were mostly similar, whereas the loss of range of motion was often higher after a Bankart repair with remplissage. Conclusions: The addition of a remplissage procedure to a Bankart repair for managing small to medium Hill-Sachs lesions might be beneficial in reducing the risk of recurrent instability and improving shoulder function, without increasing the risk of complications. Level of Evidence: Level III, systematic review of Level II and III studies.
AB - Purpose: To compare the clinical and biomechanical results of an arthroscopic Bankart repair alone with an arthroscopic Bankart repair combined with remplissage. Methods: A literature search was performed on May 1, 2018, in PubMed and Embase for studies comparing an isolated arthroscopic Bankart repair and an arthroscopic Bankart repair with remplissage. The quality of the studies was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach and the Cochrane Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) checklist. Results regarding failures, biomechanical properties, and shoulder function were extracted. Results: We included 13 studies (6 clinical and 7 biomechanical studies), and their overall quality was very low to low. In the biomechanical studies, adding a remplissage to the Bankart repair prevented engagement in all cadavers, resulted in more stiffness, and impaired the range of motion. Among clinical studies, all reported lower recurrence rates and most showed better shoulder function after a Bankart repair with remplissage compared with an isolated Bankart repair. The return-to-sport rates were mostly similar, whereas the loss of range of motion was often higher after a Bankart repair with remplissage. Conclusions: The addition of a remplissage procedure to a Bankart repair for managing small to medium Hill-Sachs lesions might be beneficial in reducing the risk of recurrent instability and improving shoulder function, without increasing the risk of complications. Level of Evidence: Level III, systematic review of Level II and III studies.
UR - http://www.scopus.com/inward/record.url?scp=85063665093&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85063665093&partnerID=8YFLogxK
U2 - 10.1016/j.arthro.2018.10.117
DO - 10.1016/j.arthro.2018.10.117
M3 - Review article
C2 - 30954117
AN - SCOPUS:85063665093
VL - 35
SP - 1257
EP - 1266
JO - Arthroscopy-the journal of arthroscopic and related surgery
JF - Arthroscopy-the journal of arthroscopic and related surgery
SN - 0749-8063
IS - 4
ER -