Abstract
Purpose
To biomechanically compare Bankart lesion repair alone and Bankart lesion repair associated with infraspinatus capsulotenodesis described as «remplissage», in the treatment of combined Bankart and Hill-Sachs lesions.
Methods
Seven pairs (right and left) of cadaveric shoulders have been tested, first without any lesion and then after performing a combined Bankart and Hill-Sachs lesions. For each pair, the specimens were then randomly assigned for Bankart lesion repair alone on one side or for Bankart lesion repair associated with remplissage on the other side. During tests, the shoulder was placed at 90° of abduction and at maximal external rotation, which value was recorded. A 50 N postero-anterior load was then applied to the proximal humerus, and the stiffness was calculated from the obtained load–displacement curve.
Results
Bankart and Hill-Sachs lesions significantly (p < 0.05) decreased joint stiffness compared with intact joint. Bankart lesion repair alone did not restore stiffness to the level of intact, while adding the remplissage to the Bankart lesion repair did. External rotation was significantly increased after creation of the Bankart and Hill-Sachs lesion; Bankart repair restored the external rotation to the level of intact, while Bankart lesion repair associated with remplissage significantly decreased external rotation compared with intact and to Bankart lesion repair alone.
Conclusion
In cadaveric shoulders with combined Bankart and Hill-Sachs lesions, Bankart lesion repair associated with remplissage restored intact joint stiffness contrary to Bankart lesion repair alone. This increase in stiffness was associated with a decrease in external rotation.
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Acknowledgments
The authors thank Smith & Nephew Europe for its financial support of this study and implants supply, the Centre du Don des Corps of the René Descartes Paris V University where the anatomic specimens were obtained.
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Grimberg, J., Diop, A., Ghosn, R.B. et al. Bankart repair versus Bankart repair plus remplissage: an in vitro biomechanical comparative study. Knee Surg Sports Traumatol Arthrosc 24, 374–380 (2016). https://doi.org/10.1007/s00167-014-3052-z
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DOI: https://doi.org/10.1007/s00167-014-3052-z