DelliCarpini Gennaro, Moore Michael, Cole Wendell, Montgomery Samuel, Stein Spencer
NYU Langone Hospital - Long Island, Mineola, USA.
Division of Sports Medicine, Department of Orthopedic Surgery, NYU Langone Health, New York, USA.
Eur J Orthop Surg Traumatol. 2025 Apr 29;35(1):175. doi: 10.1007/s00590-025-04274-9.
Remplissage is a useful adjunct to repair of the anteroinferior glenoid labrum in the treatment of anterior shoulder instability. This study aimed to compare costs and clinical outcomes between isolated arthroscopic Bankart repair (ABR) and ABR with remplissage.
This was a retrospective study of all patients who underwent arthroscopic treatment of anterior shoulder instability between June 2011 and August 2021. Patient, procedural factors, and clinical outcome data were collected. Financial data was reported as "relative costs". The best fit circle method was utilized on MRI to estimate glenoid bone loss (GBL) and the Hill Sachs Interval (HSI). Using the glenoid track, patients were determined to either have 'on' or 'off' track lesion.
48 patients who underwent ABR alone and 49 patients who underwent ABR with remplissage were matched and included in analysis. There was no significant difference in total cost, mean number of dislocations, ED visits, or revision surgery between isolated ABR and ABR with remplissage. The remplissage cohort had a significantly higher rate of "off-track" lesions (24.5% vs. 6.2%, p = 0.013), % GBL (8.7% vs. 5.7%, p = 0.015) and Hill Sachs lesion size (16.7 ± 4.1 mm vs. 8.9 ± 6.9 mm, p < 0.001).
No differences in total cost were found between ABR with or without addition of remplissage. Clinical outcomes were similar in both groups, despite a significant increase in the number of off-track lesions, HSI and GBL seen in the remplissage group. Surgeons may consider addition of remplissage in the appropriate clinical context with low concern of increased cost.
Level 3.
在治疗前肩不稳时，关节盂唇缘填充术是修复前下关节盂唇的一种有用辅助方法。本研究旨在比较单纯关节镜下Bankart修复术（ABR）与ABR联合盂唇缘填充术的成本和临床疗效。
这是一项对2011年6月至2021年8月间接受关节镜治疗前肩不稳的所有患者的回顾性研究。收集了患者、手术因素和临床疗效数据。财务数据以“相对成本”报告。在MRI上采用最佳拟合圆法评估关节盂骨缺损（GBL）和Hill-Sachs间隙（HSI）。根据关节盂轨迹，确定患者有“轨迹上”或“轨迹外”损伤。
48例单纯接受ABR的患者和49例接受ABR联合盂唇缘填充术的患者进行匹配并纳入分析。单纯ABR与ABR联合盂唇缘填充术在总成本、平均脱位次数、急诊就诊次数或翻修手术方面无显著差异。盂唇缘填充术组“轨迹外”损伤发生率（24.5%对6.2%，p = 0.013）、GBL百分比（8.7%对5.7%，p = 0.015）和Hill-Sachs损伤大小（16.7±4.1mm对8.9±6.9mm，p < 0.001）显著更高。
ABR加或不加盂唇缘填充术的总成本无差异。两组临床疗效相似，尽管盂唇缘填充术组的轨迹外损伤数量、HSI和GBL显著增加。在适当的临床情况下，外科医生可考虑增加盂唇缘填充术，而不必过于担心成本增加。
3级。
