Summary

A long term follow up (10 years) after an arthroscopic Remplissage technique augmenting the classic Bankart repair.

Abstract

Introduction- Purpose
Arthroscopic Remplissage is a surgical technique augmenting the classic Bankart repair for the management of recurrent anterior shoulder dislocations. It is a non-anatomical technique of filling the Hill Sachs lesion by folding the infraspinatus tendon and the posterior capsule. The long-term results of this procedure are well documented as far as the efficacy is concerned. However, concerns have been expressed related to the development of arthritis. The purpose of this study is to record the degenerative changes in the shoulder joint after 10 years of follow-up and the presence of osteoarthritis.

Material And Method

Thirty-two (32) patients were included in the study where they underwent surgery between January 2010 and December 2012. The surgery was performed by the same team and a single surgeon with the arthroscopic Remplissage technique augmenting the Bankart repair for anterior shoulder dislocation. It is about 26 men and 6 women with an average age of 31 years (from 18 -63). This is a retrospective study where patients underwent imaging radiographs preoperatively and after long term follow up in the operated but also in the healthy shoulder. Patients were evaluated using the modified Samilson-Priesto classification for osteoarthritis according to Allain. The average follow-up was 120 months (88-160 months).

Results

?ccording to the Samilton- Priesto classification 21 patients presented with type 1, 9 patients with type 2 and 2 patients with type 3 arthritis . No one of the patients had arthritis clinically. Most of them had stage 1-2 type of osteoarthritis Compared to the other hand of each patient, there was no difference with no statistically significant difference. (p>0.05) Few patients (6%) had developed stage 3 (only 2 of 32). Nevertheless some anatomical abnormalities were observed. like subchondral cysts, calcified tendonitis or mild irregularities inferiorly to the glenohumeral joint without any so significant clinically difference in the last decade of follow up

Conclusions

Patients treated with the Remplissage technique for anterior shoulder dislocations after a decade of follow-up have no significant osteoarthritis development of the operated shoulder except for some anatomical lesions due to the nature of the surgery.