Arthroscopic Bankart Repair and Remplissage Procedure in Patients with Recurrent Anterior Glenohumeral Dislocation with Bipolar Bone Lesions Had Low Recurrence Rate with Good Clinical Outcome

Background: Patient with recurrent shoulder dislocation suffered from shoulder instability and motion limitation. A combination of Bankart lesions and Hill-Sachs defects represented the Bipolar shoulder lesions which can cause the shoulder recurrent instability. Objectives: In this study, we demonstrate our clinical result of arthroscopic Bankart repair and remplissage procedure for the shoulder bipolar bone lesion in recurrent anterior glenohumeral dislocation patients. Materials and Methods: From January 2018 to January 2021, 23 consecutive patients (24 shoulders) who had experienced repeated anterior glenohumeral dislocation for over 2 times underwent the operation of arthroscopic Bankart repair and remplissage procedure. These patients were reviewed retrospectively. The presence of postoperative dislocation, complication, range of motion and patient-reported satisfaction as well as pre- and postoperative posterior shoulder pain, American Shoulder and Elbow Surgeons (ASES) score, Rowe score, and Visual Analog Scale (VAS) score were recorded for assessment of clinical outcome. Results: Twenty-three patients including 12 men and 11 women with an average age of 32.4 years were enrolled in this study. With a mean follow-up time of 7.5 months, only one patient reported postoperative dislocation with series recurrent rate of 4.3%. No significant posterior shoulder pain was reported by the patients while 5 patients complained mild soreness after exercise. Eighteen patients regained normal range of motion at the last follow-up, four could perform full passive range of motion, while only one could not perform full range of motion (4.3%). Significant improvement of VAS score (4.4 vs. 0, P < 0.05), ASES score (75.6 vs. 96.2, P < 0.05), and Rowe score (42.5 vs. 91.5, P < 0.05) was observed after surgery. Twenty-one out of 23 patients (91.3%) were “very satisfied” with the operation while the remaining one patient reported “satisfied” and one “normal.” Conclusion: Arthroscopic Bankart repair with the remplissage procedure had low recurrence rate and could provide good clinical outcome including overall function and patient satisfaction for recurrent anterior glenohumeral dislocation patients with bipolar bone lesion.