No Difference in Outcomes After Remplissage or Open Bankart Repair Plus Inferior Capsular Shift in Collision and Contact Athletes With Subcritical Glenoid Bone Loss ≤10% and Off-Track Hill-Sachs Lesion.

PURPOSE

To compare functional outcomes, recurrence rate, range of motion (ROM), and return to sport between arthroscopic Bankart repair with remplissage (BR) and open Bankart repair with inferior capsular shift (OBICS) in contact and collision athletes with recurrent anterior shoulder instability.

METHODS

A prospective comparative cohort study of 90 patients separated into 2 study groups (OBICS and BR) of 45 collision and contact athletes each was conducted. All athletes had subcritical glenoid bone loss ≤10% and off-track Hill-Sach lesions. A minimum follow-up period of 5 years was established. Pre- and postoperative assessments of each group, as well as between them, were carried out. The Western Ontario Shoulder Instability Index score and the American Shoulder and Elbow Surgeons (ASES) scale were used to assess subjective outcomes. Recurrence rate, ROM, and return to sport were evaluated as objective outcomes.

RESULTS

Significant differences were reported in the Western Ontario Shoulder Instability Index and ASES scores between preoperative and postoperative values in each group. There were no significant differences between the 2 groups (P = .68 and .28). Patient rates achieving the minimal clinically important difference and the patient-acceptable satisfactory state for ASES were 81.2% OBICS, 80% BR, and 78.6% and 76.5%, respectively. Although there was no significant difference between the 2 groups (P = .74), there were 3 dislocations (7.5%) in the OBICS group and 5 (12.5%) in the BR group. No significant differences in ROM were found between the 2 groups. However, significant differences in external rotation were reported in the BR group pre- compared with postoperatively (P = .03 and .04).

CONCLUSIONS

We found no differences between the outcomes of the 2 groups. Depending on surgeon preference, BR or OBICS may be safely indicated in collision or contact athletes with subcritical glenoid bone loss ≤10% and off-track Hill-Sach lesions.

LEVEL OF EVIDENCE

Level II, prospective comparative study.