2025 ISAKOS Biennial Congress ePoster
Impact Of Remplissage On Rotator Cuff Muscle Elasticity And Early Postoperative Stiffness In Anterior Shoulder Instability Patients.
Yoshimasa Saigo, MD, Tokyo JAPAN
Daichi Morikawa, MD, PhD, Tokyo JAPAN
Hirohisa Uehara, MD, Hongo, Tokyo JAPAN
Yoshiaki Itoigawa, MD, PhD, Urayasu, Chiba JAPAN
Muneaki Ishijima, MD, PhD, Tokyo JAPAN
Juntendo university, Tokyo, Bunkyo, JAPAN
FDA Status Not Applicable
Summary
Arthroscopic Bankart Repair with Remplissage (ABRR) is widely used for managing shoulder instability, but early ROM restrictions, particularly in external rotation, are common. This study investigated the impact of Remplissage on rotator cuff muscle stiffness using shear wave elastography. Results showed that TM stiffness significantly increased post-ABRR, with ROM recovery slower compared to ABR.
ePosters will be available shortly before Congress
Abstract
Objective
Arthroscopic bankart repair with Remplissage (ABRR) is a widely adopted technique for managing anterior shoulder instability, especially in cases involving off-track lesions with no critical glenoid bone loss. Early postoperative range of motion (ROM) restrictions, particularly in external rotation (ER), have been reported following ABRR. However, it is well-documented that these restrictions tend to resolve over time and do not trigger the problematic restriction of ROM in long term follow up. This temporal resolution of ROM restrictions remains an intriguing and unresolved phenomenon. We hypothesized that these early phase ROM limitations might be caused by increased rotator cuff muscle stiffness induced by the Remplissage procedure and recover with time . The purpose of this study was to investigate the impact of Remplissage on rotator cuff muscle elasticity.
Methods
This study included 11 patients with recurrent shoulder dislocation. 7 patients with off-track lesions and without critical glenoid bone loss undergo ABRR. 4 patients with on-track lesions and without critical glenoid bone loss undergo Arthroscopic Bankart Repair (ABR). Shoulder ROMs including forward elevation (FE), internal rotation (IR) and ER in abduction (1st) and abduction (2nd) positions were measured monthly for three months postoperatively. The rotator cuff muscle elasticities including supraspinatus (SSp), infraspinatus (ISp), and teres minor (TM) were assessed using shear wave elastography (LOGIQ E10, GE Healthcare). The relative elasticities were evaluated by the ratios relative to preoperative values.
Results
For shoulder ROMs, FE and ER in 1st at 1 month after surgery and FE and ER in 1st and 2nd at 2 and 3month after surgery were significantly decreased in ABRR group compared to ABR group (p<0.05).
For relative rotator cuff muscle elasticities, all SSP, ISP, and TM were significantly increased after surgery in both ABRRR and ABR groups. The relative TM elasticities at 1 and 2 months after surgery were significantly increased in ABRR compared to ABR (p<0.05). The relative SSP and ISP muscles elasticities showed similar trends, although these changes did not reach statistical significance.
Conclusion
Our findings suggest that Remplissage procedure may be attributed to increased TM stiffness. These results imply the need for additional treatment to address early muscle stiffness and enhance ROM recovery. Further research is required to explore long-term outcomes and potential interventions for mitigating early stiffness related to Remplissage.