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Knee Surg Sports Traumatol Arthrosc. 2016 Feb;24(2):374-80. doi: 10.1007/s00167-014-3052-z. Epub 2014 May 13.

Bankart repair versus Bankart repair plus remplissage: an in vitro biomechanical comparative study.

Author information

1
Institut de Recherche en Chirurgie Orthopédique et Sportive (IRCOS), 6 Avenue Alphonse XIII, 75016, Paris, France. j.grimberg@lircos.org.
2
Equipe Biomécanique et Remodelage Osseux (EPBRO), Arts et Métiers ParisTech, 151 Boulevard de l'Hôpital, 75013, Paris, France.
3
Institut de Recherche en Chirurgie Orthopédique et Sportive (IRCOS), 6 Avenue Alphonse XIII, 75016, Paris, France.

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.

KEYWORDS:

Bankart lesion; Hill-Sachs lesion; In vitro biomechanical study; Remplissage; Shoulder instability

PMID:
24819178
DOI:
10.1007/s00167-014-3052-z
[Indexed for MEDLINE]

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