Functional Outcome of Arthroscopic Bankart and Remplissage for Recurrent Anterior Shoulder Dislocation in a Tertiary Care Trauma Center

Abstract

Introduction: Arthroscopic Bankart repair is treatment of choice for anterior shoulder instability. The bipolar bone
loss with involvement of glenoid bone loss and Hill Sach’s defect gives rise to the concept of glenoid track (on-track and off-track). Off-track HS lesion can engage with the glenoid margin, compromising the Bankart repair. Therefore
the off-track lesion needs remplissage which requires transfers of the posterior capsule and infraspinatus tendon into the Hill-Sachs defect preventing engagement of the lesion thus avoiding recurrence of instability. The objective
of this study was to evaluate the functional outcome of Arthroscopic Bankart and Remplissage for recurrent anterior shoulder dislocation.

Methods: This was a descriptive cross-sectional study conducted in a patient admitted with anterior shoulder instability for bankart repair and remplissage from 2021 to 2023 in National Trauma Centre after institutions review board approval. Data were taken from the hospital records. Patient fulfilling the inclusion criteria who underwent arthroscopic Bankart repair and Remplissage were assessed using American Shoulder and Elbow Surgeons score and
Rowe score, Range of motion. Statistical analysis was performed using SPSS.

Results: Out of the total 110 patient with anterior shoulder intability, 30 (27.27%) (20.3% to 34.3% at 90% Confiedence
Interval) patients had bankart lesion. Out of 30 patient, 18 (60%) were male with fall injury being the most common mode of injury 15 (50%). The mean Rowe score and American Shoulder and Elbow Surgeons score were 93.67±2.24 and 88±7.23 respectively at the end of 2 year follow up with decreased external rotation in all patients.

Conclusions: Arthroscopic Bankart repair with Remplisage offer favourable outcome with compromised external rotation.