Abstract
Objective
To evaluate the functional outcome of the remplissage technique, the healing of the
capsulotenodesis of the infraspinatus tendon in Hill-Sachs lesion, and the degree
of fatty infiltration of the infraspinatus muscle and its postoperative strength.
Methods
Twenty-five patients with recurrent anterior dislocation of the shoulder and Hill-Sachs
lesion with a Hardy index > 20% who underwent the remplissage arthroscopic technique
were evaluated with a minimum follow-up of 1 year. Patients underwent a clinical evaluation
(Carter-Rowe and Walch-Duplay functional scores, measurement of range of motion and
strength) and a magnetic resonance imaging (MRI) exam on the operated shoulder.
Results
Eighty-eight percent and 92% of the patients had good or excellent scores in the functional
assessments of the Carter-Rowe and Walch-Duplay scores, respectively. A mean difference
of - 1 kg in the strength of the operated limb was observed when compared with the
contralateral limb (p < 0.001), as well as a mean difference of 10° in external rotation 1 and 2 (p < 0.001), also compared with the contralateral side. All of the patients who underwent
an MRI exam presented high-grade filling of the Hill-Sachs lesion by capsulotenodesis,
as well as absence of or minimal fatty infiltration in the infraspinatus muscle.
Conclusion
The remplissage technique had good/excellent functional score results, despite the
discrete, albeit statistically significant, loss of strength and of external rotation
amplitude. Successful capsulotenodesis healing and filling of the Hill-Sachs defect
were demonstrated.
Keywords
shoulder - joint instability - recurrence - Bankart lesions - arthroscopy
