TY - JOUR
T1 - What Are the Effects of Remplissage on 6-Month Strength and Range of Motion After Arthroscopic Bankart Repair? A Multicenter Cohort Study
AU - MOON Shoulder Group
AU - Frantz, Travis L.
AU - Everhart, Joshua S.
AU - Cvetanovich, Gregory L.
AU - Neviaser, Andrew
AU - Jones, Grant L.
AU - Hettrich, Carolyn M.
AU - Wolf, Brian R.
AU - Bishop, Julie
AU - Miller, Bruce
AU - Brophy, Robert H.
AU - Ma, C. Benjamin
AU - Cox, Charlie L.
AU - Baumgarten, Keith M.
AU - Feeley, Brian T.
AU - Zhang, Alan L.
AU - McCarty, Eric C.
AU - Kuhn, John E.
N1 - Publisher Copyright:
© The Author(s) 2020.
PY - 2020/2/1
Y1 - 2020/2/1
N2 - 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° external rotation (ER) deficit with the elbow at the side, 42% had a ≥20° ER deficit with the elbow at 90° 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° ER deficit with the elbow at 90° of abduction (P =.004). Risk factors for a ≥20° ER deficit with the elbow at 90° of abduction were preoperative stiffness in the same plane (P =.02), while risk factors for a ≥20° 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.
AB - 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° external rotation (ER) deficit with the elbow at the side, 42% had a ≥20° ER deficit with the elbow at 90° 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° ER deficit with the elbow at 90° of abduction (P =.004). Risk factors for a ≥20° ER deficit with the elbow at 90° of abduction were preoperative stiffness in the same plane (P =.02), while risk factors for a ≥20° 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.
KW - Bankart repair
KW - ROM
KW - remplissage
KW - shoulder arthroscopic surgery
KW - strength
UR - http://www.scopus.com/inward/record.url?scp=85081369459&partnerID=8YFLogxK
U2 - 10.1177/2325967120903283
DO - 10.1177/2325967120903283
M3 - Article
C2 - 33283013
AN - SCOPUS:85081369459
SN - 2325-9671
VL - 8
JO - Orthopaedic Journal of Sports Medicine
JF - Orthopaedic Journal of Sports Medicine
IS - 2
ER -