A short term analysis of external rotation deficit following a combined arthroscopic bankart with remplissage and rotator interval closure for anteroinferior instability with subcritical bone loss

Abstract

Background: Our study aims at assessing the clinical outcomes of our patients who have undergone arthroscopic bankart and remplissage along with rotator interval closure in the treatment of anteroinferior instability with subcritical bone loss, with focus on external rotation deficit. Methods: This is a single-center retrospective study including 48 consecutive patients who underwent surgery Arthroscopic Bankarts with remplissage procedure for anterior shoulder instability with Hill-Sachs lesion. In our study, the minimum follow-up was 6 months and the average follow-up of was 21months. At the last follow-up, active range of motion, western ontario shoulder instability index (WOSI) and University of California at Los Angeles (UCLA) scores were assessed. Results: 48 patients who underwent surgery in the time period of 2019-2023 who completed minimum 6months follow up were included in the study. The average age of the patients was 31.7 years (range, 16-52 years), with 93.8% male patients and 6.2% female patients. The range of motion at follow-up was comparable with the normal side, with loss of terminal external rotation in 2 patients (4%). Average University of California at Los Angeles score was 30.7 and Western Ontario shoulder instability index was 3.8%. One patient had only one episode of subluxation and there was one case of infection. Conclusions: The results of our study validate the combination of Remplissage and rotator interval closure with Bankart repair in the treatment of anterior instability with glenoid bone loss <15% irrespective of tracking of Hill Sachs lesion for excellent functional outcomes, least rate of recurrence and without significant loss of external rotation.