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RESULTS FROM FILLING "REMPLISSAGE" ARTHROSCOPIC TECHNIQUE FOR RECURRENT ANTERIOR SHOULDER DISLOCATION.

Research paper by Mauro Emilio Conforto ME Gracitelli, Camilo Partezani CP Helito, Eduardo Angeli EA Malavolta, Arnaldo Amado Ferreira AA Neto, Eduardo E Benegas, Flávia de Santis Fde S Prada, Augusto Tadeu Barros AT de Sousa, Jorge Henrique JH Assunção, Edwin Eiji EE Sunada

Indexed on: 01 Nov '11Published on: 01 Nov '11Published in: Revista Brasileira de Ortopedia (English Edition)



Abstract

To evaluate the clinical result from the filling ("remplissage") technique in association with Bankart lesion repair for treating recurrent anterior shoulder dislocation.Nine patients (10 shoulders), with a mean follow-up of 13.7 months, presented traumatic recurrent anterior shoulder dislocation. All of them had a Bankart lesion, associated with a Hill-Sachs lesion showing the "engaging" sign. The Hill-Sachs lesion defect was measured and showed an average bone loss of 17.3% (7.7% to 26.7%) in relation to the diameter of the humeral head. All the cases underwent arthroscopic repair of the Bankart lesion, together with filling of the Hill-Sachs lesion by means of tenodesis of the infraspinatus.The Rowe score ranged from 22.5 (10 to 45) before the operation to 80.5 (5 to 100) after the operation (p > 0.001). The UCLA score ranged from 18.0 (8 to 29) to 31.1 (21 to 31) (p > 0.001). The measurements of external and internal rotation at abduction of 90° after the operation were 63.5° (45° to 90°) and 73° (50° to 92°) respectively. Two patients presented recurrence (one with dislocation and the other with subluxation). None of the patients presented pain in the region of the infraspinatus tendon after the operation.Over the short term, the filling ("remplissage") arthroscopic technique produced improvements in functional scores and a low complication rate when used for treating glenohumeral instability associated with Hill-Sachs lesions.