Outcomes of Latarjet Procedure Versus Bankart Repair With Remplissage in Recurrent Anterior Shoulder Dislocation with Bipolar Bony Defects

Background: Recurrent anterior instability may be associated with a high incidence of humeral and/or glenoid bone lesions reaching between 90% and 95% of the patients. Studies have shown that in case of failure to address significant bony lesions either on the glenoid side, humeral side or both sides (bipolar lesions), poor outcomes would be obtained after Bankart repair. Materials and methods: A randomized clinical trial study was conducted on fifty patients with recurrent anterior shoulder dislocation and bipolar bony lesions. The patients were divided randomly into 2 groups using a simple randomization: group 1 was treated by arthroscopic Remplissage with a Bankart repair (RB) and group 2 was treated by open Latarjet procedure. All patients enrolled in this study were examined thoroughly for their pre and postoperative range of motion and shoulder stability. All patients were assessed pre and postoperatively according to Rowe, and Walch-Duplay scores. Results: The Remplissage Bankart group (RB) included 16 males (64%) and 9 females (36%) with a mean age of 22.6 years old (range 19-28 years old). The patients in both groups showed significant improvement of Rowe, and Walch-Duplay scores at the final follow up. Conclusion: Both Remplissage and Latarjet procedures are safe and reliable and provide satisfactory outcomes. However, the Remplissage group had a significant decrease in the external rotation range of motion rather than in the Latarjet group.