Remplissage of an off-track hill-sachs lesion is necessary to restore biomechanical glenohumeral joint stability in a bipolar bone loss model

Hartzler, Robert U.; Bui, Christopher; Jeong, Woong Kyo; Akeda, Masaki; Peterson, Alex; McGarry, Michelle H.; Denard, Patrick J.; Burkhart, Stephen S.; Lee, Thay Q.

doi:10.1016/j.jse.2016.07.051

Cited by 17 publications

(29 citation statements)

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“…Studies investigating the consequences of humeral bone loss, such as those by Itoi et al [20], have led to innovation in arthroscopic stabilization by identifying a potential cause of failure following "simple" Bankart repair. Hartzler et al further explored this theory by performing a biomechanical analysis of the glenoid track concept following Bankart repair with and without remplissage of the HS lesion [71]. The authors found that the addition of remplissage prevented HS engagement in all shoulders with large lesions which were not otherwise stabilized with Bankart repair alone [71].…”

Section: Future Directionsmentioning

confidence: 99%

“…Hartzler et al further explored this theory by performing a biomechanical analysis of the glenoid track concept following Bankart repair with and without remplissage of the HS lesion [71]. The authors found that the addition of remplissage prevented HS engagement in all shoulders with large lesions which were not otherwise stabilized with Bankart repair alone [71]. Ko et al examined the clinical outcomes of concomitant remplissage in patients with engaging HS lesions undergoing Bankart repair [72].…”

Section: Future Directionsmentioning

confidence: 99%

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Arthroscopic Bankart Repair for the Management of Anterior Shoulder Instability: Indications and Outcomes

DeFroda

Bokshan

Stern

et al. 2017

Curr Rev Musculoskelet Med

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Purpose of Review Arthroscopic Bankart repair is commonly utilized for shoulder stabilization in patients with anterior shoulder instability with minimum glenoid bone loss. The purpose of this review is to provide the indications, surgical technique, complications, and recent outcomes in arthroscopic Bankart repair for shoulder instability. Recent Findings Improvements in arthroscopic techniques have led to better patient outcomes, as well as an improved understanding of the pathoanatomy of instability. More recent studies have shown that one of the potential failures of primary arthroscopic repair may be due to unaddressed bone loss. This underscores the importance of evaluating glenoid bone loss and proper patient selection for this procedure to ensure successful outcome. Summary When indicated, arthroscopic stabilization is the treatment of choice for many surgeons due to its lower morbidity and low overall complication rate. Future work must focus on longer-term outcomes in patients undergoing arthroscopic Bankart repair, as well as the clinical outcomes of new fixation techniques, augmentation techniques, and the effect of glenoid bone loss in outcome.

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Section: Future Directionsmentioning

confidence: 99%

Section: Future Directionsmentioning

confidence: 99%

Arthroscopic Bankart Repair for the Management of Anterior Shoulder Instability: Indications and Outcomes

DeFroda

Bokshan

Stern

et al. 2017

Curr Rev Musculoskelet Med

View full text Add to dashboard Cite

show abstract

“…In another cadaveric study that sought to validate the glenoid track concept [8], the authors used eight cadaver shoulders. Glenoid bone loss was created to equate to 15% and coupled with on-track (15%) or off-track (30%) HillSachs lesions.…”

Section: Glenoid Track Conceptmentioning

confidence: 99%

Applying the Glenoid Track Concept in the Management of Patients with Anterior Shoulder Instability

Momaya

Tokish

2017

Curr Rev Musculoskelet Med

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Purpose of Review The purpose of this paper is to evaluate the recent evolution in the treatment of anterior shoulder instability and the dynamic interaction between the glenoid and HillSachs lesion. Recent Findings Through the glenoid track concept, glenoidand humeral-sided bone loss are evolving away from being approached as separate entities. Recent cadaveric studies have validated the glenoid track concept. Moreover, a recent clinical study has demonstrated a much higher rate of failure after arthroscopic Bankart repair for shoulders that were off track. Summary The glenoid track concept is a useful tool in evaluating patients with anterior shoulder instability. Shoulders that are off track may require more than a simple arthroscopic Bankart, and the addition of a remplissage or bony transfer may be considered.

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“…5 Soon afterward, I was fortunate to be able to conduct a biomechanical study in Dr. Thay Lee's lab that validated our treatment paradigm for bone loss in instability from a biomechanical standpoint. 6 Through all of these experiences, I have maintained a keen appreciation for investigators who have contributed to our understanding of bone loss in instability.…”

Section: See Related Article On Page 1755mentioning

confidence: 99%

Editorial Commentary: Off-Track Hill-Sachs Lesions in Adolescents With Multiple Anterior Dislocations: The Case for Stabilizing Adolescent First-Time Dislocators

Burkhart¹

2017

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Remplissage of an off-track hill-sachs lesion is necessary to restore biomechanical glenohumeral joint stability in a bipolar bone loss model

Cited by 17 publications

References 0 publications

Arthroscopic Bankart Repair for the Management of Anterior Shoulder Instability: Indications and Outcomes

Arthroscopic Bankart Repair for the Management of Anterior Shoulder Instability: Indications and Outcomes

Applying the Glenoid Track Concept in the Management of Patients with Anterior Shoulder Instability

Editorial Commentary: Off-Track Hill-Sachs Lesions in Adolescents With Multiple Anterior Dislocations: The Case for Stabilizing Adolescent First-Time Dislocators

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