Dr. Logan on Shoulder Dislocations/Shoulder Instability

A level I RCT published in the March 2020 issue of JBJS titled Primary Arthroscopic Stabilization for a First-Time Anterior Dislocation of the Shoulder, a single-center double-blinded clinical trial compared arthroscopic washout to arthroscopic Bankart repair for the management of primary anterior shoulder instability.

At an average follow up of 14 years, the rate of recurrent dislocation was significantly higher in the washout group compared to the Bankart repair group, at 47% compared to 12%. 

The arthroscopic Bankart repair group also demonstrated significantly better clinical outcome scores, including the WOSI and DASH scores. Then, from the June issue of JSES this year, we review the publication titled Remplissage Reduces Recurrent Instability in High-risk Patients with On-track Hill-Sachs Lesions.  Albert Lin and Pat Denard performed a multicenter retrospective study of patients with on-track Hill Sachs lesions who underwent arthroscopic Bankart repair with or without the addition of a Remplissage procedure.

On this episode of The Sports Docs Podcast, we discussed on-track versus off-track Hill Sachs lesions, how you go about calculating this and what to do with this information in a little bit with our guest. So, for now, we’ll just focus on the results of this study, which showed that the addition of a remplissage was associated with a lower rate of recurrent dislocation (1.8% vs. 11%) and revision surgery (0% vs. 6%). Remplissage protected against recurrent instability, particularly in high-risk patients.

Author

Dr. Catherine Logan, MD, MBA Catherine Logan, MD, MBA, MSPT, is a sports medicine orthopaedic surgeon specializing in complex knee and shoulder surgery at Colorado Sports Medicine and Orthopaedics (COSMO) in Denver, Colorado. As a former physical therapist & trainer, Dr. Logan provides a distinct expertise in sports injury, prevention, and surgical management.