[Clinical outcomes of arthroscopic Bankart repair combined with Remplissage for recurrent anterior shoulder instability with glenoid bone loss≤20].

Objective: To investigate the clinical efficacy of Bankart repair combined with Remplissage procedure in the treatment of anterior shoulder instability with glenoid bone defect≤20%. Methods: A retrospective analysis was conducted on patients with recurrent anterior shoulder dislocation combined with Hill-Sachs lesions admitted to Huashan Hospital, Fudan University from January 2020 to June 2024. All patients were confirmed with a glenoid bone defect≤20% by three-dimensional computed tomography (CT) reconstruction of the shoulder joint. The Constant-Murley score, American Shoulder and Elbow Surgeons (ASES) score, Rowe score, University of California Los Angeles (UCLA) score, and shoulder range of motion were evaluated before surgery and at the last follow-up. The postoperative function and return to sports were observed between patients with 13.5%≤glenoid bone defect≤20% and those with glenoid bone defect<13.5%. Results: A total of 40 patients were included, with an age of (26±6) years, including 35 males and 5 females. The follow-up time was (25.8±12.4) months. The postoperative UCLA score [(33.4±1.1) vs (22.1±3.4)], ASES score [(93.0±4.8) vs (73.3±9.6)], Constant-Murley score [(93.5±4.9) vs (79.3±7.0)], and Rowe score [(96.0±4.1) vs (39.2±9.4)] were all improved compared with those before surgery (all P<0.001). There were no statistically significant differences in postoperative angles of forward flexion, abduction, external rotation at the side, and the spinous process level of internal rotation at the side compared with those before surgery (all P>0.05). No complications such as infection or joint adhesion occurred in any of the patients postoperatively, and there was no recurrence of dislocation. At the last follow-up, all patients returned to sports, of which 31 cases (31/40, 77.5%) returned to the preoperative sports level. There was no statistically significant difference in postoperative function between patients with 13.5%≤glenoid bone defect≤20.0% and those with glenoid bone defect<13.5%, but the proportion of returning to the preoperative sports level (13/21 vs 18/19) showed a statistically significant difference (P<0.05). Conclusion: Arthroscopic Bankart repair combined with Remplissage procedure for patients with recurrent anterior shoulder dislocation combined with Hill-Sachs lesions and a glenoid bone defect≤20% can restore joint stability, improve shoulder function, and does not affect the joint range of motion.