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What Are the Effects of Remplissage on 6-Month Strength and Range of Motion After Arthroscopic Bankart Repair? A Multicenter Cohort Study
Journal article   Open access   Peer reviewed

What Are the Effects of Remplissage on 6-Month Strength and Range of Motion After Arthroscopic Bankart Repair? A Multicenter Cohort Study

Travis L. Frantz, Joshua S. Everhart, Gregory L. Cvetanovich, Andrew Neviaser, Grant L. Jones, Carolyn M. Hettrich, Brian R. Wolf, Julie Bishop and MOON Shoulder Group
Orthopaedic journal of sports medicine, Vol.8(2), pp.2325967120903283-2325967120903283
02/01/2020
DOI: 10.1177/2325967120903283
PMCID: PMC7686606
PMID: 33283013
url
https://doi.org/10.1177/2325967120903283View
Published (Version of record) Open Access

Abstract

Background: Patients who have undergone shoulder instability surgery are often allowed to return to sports, work, and high-level activity based largely on a time-based criterion of 6 months postoperatively. However, some believe that advancing activity after surgery should be dependent on the return of strength and range of motion (ROM). Hypothesis: There will be a significant loss of strength or ROM at 6 months after arthroscopic Bankart repair with remplissage compared with Bankart repair alone. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 38 patients in a prospective multicenter study underwent arthroscopic Bankart repair with remplissage (33 males, 5 females; mean age, 27.0 +/- 10.2 years; 82% with >= 2 dislocation events in the past year). Strength and ROM were assessed preoperatively and at 6 months after surgery. Results were compared with 104 matched patients who had undergone Bankart repair without remplissage, although all had radiographic evidence of a Hill-Sachs defect. Results: At 6 months, there were no patients in the remplissage group with anterior apprehension on physical examination. However, 26% had a >= 20 degrees external rotation (ER) deficit with the elbow at the side, 42% had a >= 20 degrees ER deficit with the elbow at 90 degrees of abduction, and 5% had persistent weakness. Compared with matched patients who underwent only arthroscopic Bankart repair, the remplissage group had greater humeral bone loss and had a greater likelihood of a >= 20 degrees ER deficit with the elbow at 90 degrees of abduction (P = .004). Risk factors for a >= 20 degrees ER deficit with the elbow at 90 degrees of abduction were preoperative stiffness in the same plane (P = .02), while risk factors for a >= 20 degrees ER deficit with the elbow at the side were increased number of inferior quadrant glenoid anchors (P = .003), increased patient age (P = .02), and preoperative side-to-side deficits in ER (P = .04). The only risk factor for postoperative ER weakness was preoperative ER weakness (P = .04), with no association with remplissage (P = .26). Conclusion: Arthroscopic Bankart repair with remplissage did not result in significant strength deficits but increased the risk of ER stiffness in abduction compared with Bankart repair without remplissage at short-term follow-up.
 Orthopedics Life Sciences & Biomedicine Science & Technology Sport Sciences

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