• Hill-Sachs
• Remplissage
• Shoulder
• Shoulder dislocation
• Shoulder instability

• Bankart repair
• Hill-Sachs lesion
• anterior shoulder instability
• finite element analysis
• remplissage
• shoulder kinematics

• Bankart
• Latarjet
• external rotation
• meta-analysis
• remplissage
• systematic review

• Humans
• Arthroscopy/methods
• Rotation
• Joint Instability/surgery
• Bankart Lesions/surgery
• Recurrence
• Shoulder Dislocation/surgery

• arthroscopic Bankart and remplissage
• athletes
• glenohumeral instability
• open Latarjet

• Humans
• Arthroscopy/methods
• Male
• Retrospective Studies
• Female
• Adult
• Return to Sport
• Joint Instability/surgery
• Young Adult
• Shoulder Joint/surgery
• Shoulder Joint/physiopathology
• Range of Motion, Articular
• Glenoid Cavity/surgery
• Shoulder Dislocation/surgery
• Magnetic Resonance Imaging
• Bankart Lesions/surgery
• Tomography, X-Ray Computed
• Adolescent
• Athletic Injuries/surgery

• None

• Arthroscopic Latarjet
• Bankart repair
• Hill-Sachs remplissage
• bipolar bone loss
• epilepsy
• glenoid bone loss
• recurrent anterior instability

• Humans
• Adult
• Male
• Female
• Arthroscopy/methods
• Prospective Studies
• Bankart Lesions/surgery
• Joint Instability/surgery
• Young Adult
• Shoulder Joint/surgery
• Shoulder Dislocation/surgery

• Bankart lesion
• Distal clavicle autograft
• Distal tibia allograft
• Remplissage
• Shoulder dislocation
• Shoulder instability

• Humans
• Arthroscopy/methods
• Joint Instability/surgery
• Athletic Injuries/surgery
• Shoulder Dislocation/surgery
• Shoulder Joint/surgery
• Shoulder Joint/physiopathology
• Shoulder Injuries/surgery

• Anterior dislocation
• Anterior instability
• Bibliometric analysis
• Development trend
• Global status
• Shoulder diseases

• Hill-Sachs lesion
• Remplissage
• anterior shoulder instability
• arthroscopic

• Hill–Sachs lesion
• Latarjet
• anterior instability
• bipolar bone loss
• humeral head osteochondral bulk allograft

• Bankart repair
• Hill-Sachs lesion
• anterior shoulder instability
• recurrent shoulder instability
• remplissage

• Humans
• Arthroscopy/methods
• Range of Motion, Articular
• Joint Instability/surgery
• Joint Instability/physiopathology
• Recurrence
• Shoulder Joint/surgery
• Shoulder Joint/physiopathology
• Shoulder Dislocation/surgery
• Bankart Lesions/surgery
• Treatment Outcome
• Return to Sport

• None

• Bankart repair
• Hill-Sach’s lesion
• On-track
• Overhead athletes
• Remplissage

• Humans
• Shoulder Joint/surgery
• Shoulder/surgery
• Shoulder Dislocation/surgery
• Retrospective Studies
• Joint Instability/surgery
• Return to Sport
• Athletes
• Arthroscopy/methods
• Basketball
• Recurrence

• Bankart
• Instability
• Latarjet
• dislocation
• glenoid bone loss
• recurrence
• shoulder

• Humans
• Orthopedic Surgeons
• Cross-Sectional Studies
• Canada
• Surveys and Questionnaires

• Bankart
• Latarjet
• Shoulder instability
• anterior bone block reconstruction
• complications
• cost

• Bankart lesion
• Hill-Sachs lesion
• Latarjet
• glenoid bone loss
• shoulder dislocation
• shoulder instability

• Bankart
• Hill-Sachs lesion
• Latarjet
• glenohumeral dislocation
• glenoid bone loss
• off-track
• on-track
• remplissage
• shoulder instability

• Bankart
• Latarjet
• Remplissage
• pither
• shoulder instability

• Male
• Humans
• Adolescent
• Joint Instability/etiology
• Joint Instability/surgery
• Baseball
• Bankart Lesions/surgery
• Shoulder
• Shoulder Joint/surgery

• Bankart Lesions/surgery
• Biomechanical Phenomena
• Humans
• Joint Instability/pathology
• Joint Instability/surgery
• Shoulder Dislocation/surgery
• Shoulder Joint/surgery

Treatment for patients with anterior glenohumeral instability with subcritical bone loss is evolving. The purpose of this study was to compare 2-year outcomes of arthroscopic Bankart repair with and without Hill–Sachs remplissage in patients with <15% glenoid bone loss.

A multicenter retrospective study was performed on a consecutive series of patients who underwent primary isolated arthroscopic Bankart repair (IBR) or arthroscopic Bankart repair with remplissage (REMP) by 4 shoulder specialists between 2013 and 2019. Range of motion (ROM) and patient-reported outcomes (PROs) were collected at baseline and 2 years postoperative: Western Ontario Shoulder Instability Index, Single Assessment Numeric Evaluation, and visual analog scale for pain. Recurrence, return to sport, satisfaction, complications, and revisions also were reviewed.

A total of 123 patients were available, including 75 IBR and 48 REMP. Baseline demographics, activity, ROM, and PROs were similar. Mean glenoid bone loss (2.5% vs 6.1%: P < .001) was greater in REMP, although the number of on-track lesions was similar (98.7% vs 93.8%: P = .298). WOSI scores were improved for REMP (196.5 vs 42.7: P = .004), but otherwise no difference in postoperative PROs or ROM. Differences between cohorts did not reach significance in return to sport (73% vs 83%: P = .203), recurrence (9.3% vs 2.1%: P = .148), or revisions (6.8% vs 2.1%: P = .403). For on-track lesions there were 6 recurrences in IBR (6 of 74; 8.1%) and 1 recurrence in REMP (1 of 45; 2.2%).

Despite slightly worse pathology, patients with subcritical bone loss who undergo REMP experience similar short-term postoperative function to isolated IBR. Recurrence, revision, and return to sport favored REMP but this study was underpowered to show statistical significance. Recurrence was common following IBR, despite subcritical glenoid bone loss and primarily on-track lesions, suggesting that REMP can be considered in on-track lesions.

III, retrospective comparative study.

• Glenoid track
• Hill-Sachs
• Remplissage
• Subcritical glenoid bone loss

• Bankart lesion
• Collision and contact athlete
• Magnetic resonance arthrography
• Surgical outcomes
• Three-dimensionally reconstructed CT
• Unstable painful shoulder

• Arthroscopy
• Hill–Sachs
• Instability
• Remplissage
• Shoulder

• Arthroscopy
• Cohort Studies
• Follow-Up Studies
• Humans
• Joint Instability/diagnostic imaging
• Joint Instability/surgery
• Magnetic Resonance Imaging
• Magnetic Resonance Spectroscopy
• Recurrence
• Retrospective Studies
• Shoulder Dislocation/diagnostic imaging
• Shoulder Dislocation/surgery
• Shoulder Joint/diagnostic imaging
• Shoulder Joint/surgery

Different techniques are used for the remplissage procedure, including the double-pulley and mattress suture techniques. Both techniques have shown good results; however, it is unclear if one technique is superior.

The remplissage procedure using the double-pulley technique with 2 anchors would have superior functional and radiological outcomes compared with the mattress suture technique with a single anchor.

Cohort study; Level of evidence, 3.

This study included patients with anterior shoulder instability who were treated using arthroscopic Bankart repair combined with remplissage between 2012 and 2017. A structured questionnaire was used to gather information on the following metrics: Instability Severity Index Score, hyperlaxity, Sugaya index, presence of a Hill-Sachs defect, number of dislocations before surgery, sports participation, radiological measurement of the Hill-Sachs lesion, postoperative range of motion in both shoulders, Rowe score, Walch-Duplay score, American Shoulder and Elbow Surgeons score, and Filling Index Score of Remplissage grade according to magnetic resonance imaging scans at the last follow-up.

There were 41 patients included with a mean age of 30 ± 7 years who underwent the Hill-Sachs remplissage procedure using the double-pulley technique with 2 anchors (n = 21; group DA) or the mattress suture technique with a single anchor (n = 20; group SA). At the final follow-up, there were no significant differences between the groups regarding the Instability Severity Index Score (P = .134), the Sugaya index (P = .538), sports participation (P = .41), the radiological measurement of the Hill-Sachs lesion (P = .803), or the Rowe score (P = .182). However, there were significant differences between the groups in the Walch-Duplay score (P = .012), American Shoulder and Elbow Surgeons score (P = .005), and Filling Index Score of Remplissage grade (P = .015), favoring group DA, as well as differences in external rotation in a neutral position (external rotation loss: 9° ± 3° [group SA] vs 12° ± 3° [group DA]; P = .003) and at 90° of abduction (external rotation loss: 8° ± 3° [group SA] vs 11° ± 3° [group DA]; P = .006), favoring group SA.

In the remplissage procedure, the double-pulley technique provided better filling of the lesion and improvement in functional scores, but external rotation was limited compared with the mattress suture technique.

• Hill-Sachs
• double pulley
• instability
• mattress suture
• remplissage
• technique

• Bankart repair
• Hill-Sachs lesion
• Shoulder
• arthroscopy
• dislocation
• instability
• remplissage

• Bankart repair
• Hill-Sachs remplissage
• collision athlete
• rotator interval closure
• shoulder instability
• surgical outcomes

Although Bankart repair with remplissage is commonly performed to treat anterior shoulder instability, there is limited information on specific outcomes or patients’ fears regarding return to sports (RTS).

To study recurrence rates, pain, shoulder function, active range of motion (ROM), RTS rate, and patients’ fears and expectations for RTS after arthroscopic Bankart repair with remplissage for anterior shoulder instability. We compared these outcomes with those after Bankart repair alone.

Cohort study; Level of evidence, 3.

A retrospective cohort study was carried out between 2007 and 2017 among patients who underwent arthroscopic Bankart repair with remplissage (group BR) and Bankart repair alone (group B). At the final follow-up, outcomes including recurrence, pain, shoulder function, active ROM, RTS rate, and fear toward RTS were assessed. The specific outcomes for RTS were evaluated based on 3 levels: return to normal life, RTS at any level (RTSA), and RTS at previous level (RTSP).

A total of 70 patients were included (29 in group BR and 41 in group B) with a mean 67.2 months of follow-up. Group BR demonstrated a significantly lower recurrence rate than did group B (0 vs 22.0%, respectively; P = .007) as well as higher postoperative Rowe score (92.8 ± 7.1 vs 83.3 ± 16.2, respectively; P = .005). There were no differences between the groups in postoperative visual analog scale for pain score, American Shoulder and Elbow Surgeons score, Oxford Shoulder Instability Score, or active ROM. The rates of RTSA (100% vs 84.2%; P = .03) and RTSP (77.8% vs 50.0%; P = .02) were higher in group BR than in group B, respectively, and significantly fewer patients in group BR reported fear of RTS (40.7% vs 63.2%; P = .04).

In this study, recurrence rate, pain, shoulder function, active ROM, and RTS rate were satisfactory after arthroscopic Bankart repair with remplissage. Patients who underwent this procedure reported less fear toward RTS and higher rates of RTSA and RTSP than did those who undergo Bankart repair alone.

• Bankart repair
• anterior shoulder instability
• arthroscopy
• remplissage
• return to sport

Latarjet has become a common treatment option for patients with shoulder instability in the setting of bone loss. The coracoid is commonly secured with screws

All patients who underwent Latarjet with suture-button fixation with minimum 1-year follow-up were eligible for inclusion. Preoperative demographic and clinical outcome data including American Shoulder and Elbow Surgeons (ASES), Single Assessment Numerical Evaluation (SANE), and Visual Analog Scale (VAS) were recorded and compared with postoperative scores. Radiographs were reviewed for signs of nonunion. Complications were recorded.

Overall 21 patients (76% male, average age: 30.4 ± 11.3 years) underwent Latarjet with suture-button fixation. Significant improvements at 1 year were seen in ASES (P < 0.001), SANE (P < 0.001), and VAS (P = 0.011) scores compared with preoperative scores. Of the 21 patients who had reached 1-year follow-up, 17 (81%) reached 2-year follow-up. For the 17 patients who reached 2-year follow-up, there were significant improvements in ASES (P = 0.001), SANE (P = 0.001), and VAS (P = 0.005) scores from preoperative values. When isolating the 17 patients with 2-year follow-up, there were no significant differences between their 1-year and 2-year ASES (P = 0.73), SANE (P = 0.17), and VAS (P = 0.37) scores. Overall, 3 patients (14%) sustained a complication (one redislocation, one with coracoid migration and a fibrous union, and one superior labral tear requiring biceps tenodesis and superior labral repair).

Suture-button fixation of the coracoid during the Latarjet provides encouraging clinical and radiographic outcomes at 1 and 2 years.

• Latarjet
• bone loss
• dislocation
• outcome
• shoulder instability
• suture button

• Bankart
• Latarjet
• anterior shoulder instability
• arthroscopy
• remplissage
• systematic review

• Arthroscopy
• Bankart Lesions
• Humans
• Joint Instability/surgery
• Recurrence
• Shoulder
• Shoulder Dislocation/surgery
• Shoulder Joint/surgery

• Hill-Sachs lesion
• Latarjet
• Shoulder instability
• glenoid bone loss
• remplissage

• Hill-Sachs lesion
• arthroscopic Bankart
• glenoid bone loss
• shoulder instability

• Arthroscopic bankart
• Arthroscopic stabilisation
• Remplissage
• Shoulder instability

• Anterior shoulder instability
• Bankart surgery
• Hill–Sachs
• McLaughlin procedure
• Remplissage
• Shoulder dislocation

• Allografts
• Arthroscopy/methods
• Bankart Lesions/complications
• Bankart Lesions/surgery
• Bone Transplantation/methods
• Humans
• Joint Instability/etiology
• Joint Instability/surgery
• Male
• Young Adult

• Arthroscopy
• Bankart
• Dislocation
• Instability
• Latarjet
• Shoulder
• Subluxation

• Bankart repair
• ROM
• remplissage
• shoulder arthroscopic surgery
• strength

• Arthroscopy
• Recurrence
• Remplissage
• Shoulder
• Shoulder instability
• Surgery

With the rise of adolescent sports participation, there has been a concomitant increase in not only the incidence but also the treatment of traumatic shoulder instability. Yet, there have been limited data on the failure rates of arthroscopic shoulder stabilization in this population as well as the potential risk factors.

The purpose of this study was to determine the failure rates of adolescent patients who underwent arthroscopic labral reconstruction for traumatic anterior shoulder instability. We hypothesized that adolescent failure rates would be significantly higher than what has been reported in the adult population with regard to recurrent instability after surgical intervention.

Case series; Level of evidence, 4.

This was a retrospective cohort study performed at a single center. Inclusion criteria consisted of all adolescent-aged patients identified who (1) had traumatic anterior shoulder instability, (2) had radiographic findings consistent with anteroinferior capsulolabral injury, and (3) underwent arthroscopic shoulder stabilization. Patient demographics, clinical presentation, imaging, intraoperative findings, and postoperative outcomes were analyzed.

A total of 36 patients were identified, with a mean ± SD follow-up of 35.6 ± 13.8 months. The mean patient age at the time of the index procedure was 16.03 ± 1.67 years. All patients underwent arthroscopic shoulder stabilization consisting of arthroscopic Bankart repair. Twelve patients (33.3%) reported either recurrent instability or apprehension, of whom 9 (25.0%) developed recurrent dislocation/subluxation at a mean of 20.67 months postoperatively (range, 16-51 months). No single sport was associated with a statistically significant increased risk of redislocation, although a trend was seen toward those with postoperative participation in high-risk sporting activity. Patients who redislocated their shoulders had a higher frequency of a Hill-Sachs lesion on magnetic resonance imaging (89%) compared with those who did not (52%, P = .048). History of multiple preoperative dislocations, presence of bony Bankart pathology, off-track lesions, and number of anchors utilized were not associated with postoperative dislocation/subluxation.

This study demonstrates that adolescent patients treated with arthroscopic shoulder stabilization have a high rate of recurrent instability. The adolescent population may benefit from other stabilization strategies and/or activity modification. Further studies are necessary to determine the reasons for the high rate of redislocation and to develop strategies for prevention.

• Bankart
• adolescent
• arthroscopy
• recurrence rate
• shoulder instability
• stabilization