During a Bankart repair, the torn labrum (a ring of cartilage that surrounds the glenoid) is repaired or reattached to the glenoid using sutures. However, in cases where a large Hill-Sachs lesion is present, there is a risk of the humeral head engaging with the glenoid defect and causing recurrent instability.
To address this issue, the remplissage procedure is performed in conjunction with the Bankart repair. In remplissage, the infraspinatus tendon (a muscle in the back of the shoulder) is transferred and placed into the Hill-Sachs defect, effectively filling the defect and creating a barrier to engagement.
This combined approach of Bankart repair with remplissage has been shown to lower the recurrent dislocation rate in cases with significant Hill-Sachs lesions. The presence of remplissage helps prevent engagement of the humeral head in the glenoid defect, reducing the risk of subsequent dislocations.
Several studies have reported positive outcomes with the Bankart repair and remplissage technique, demonstrating improved stability and reduced rates of recurrent dislocation in patients with significant Hill-Sachs lesions.
However, it's important to note that the decision to perform Bankart repair with remplissage depends on various factors, including the size and severity of the Hill-Sachs lesion, patient characteristics, and surgeon expertise. A thorough evaluation by an orthopedic surgeon is necessary to determine the most appropriate surgical approach for each individual case.
In summary, Bankart repair with remplissage is a surgical technique that combines the repair of a torn labrum with the filling of a Hill-Sachs lesion to enhance stability and reduce the risk of recurrent shoulder dislocations. It can be an effective treatment option for patients with significant Hill-Sachs lesions and recurrent instability.
Bankart repair is a surgical procedure performed to address shoulder instability, specifically anterior shoulder instability. It is named after the surgeon who first described the technique, Dr. Arthur Bankart.
Anterior shoulder instability occurs when the humeral head (upper arm bone) dislocates or partially dislocates from the glenoid (shoulder socket) in a forward direction. This can result in recurrent shoulder dislocations and a feeling of instability.
During a Bankart repair, the torn labrum (a ring of cartilage that surrounds the glenoid) is repaired or reattached to the glenoid using sutures. The labrum acts as a stabilizing structure for the shoulder joint, and repairing it helps restore stability and prevent further dislocations.
The surgery is typically performed arthroscopically, using small incisions and a camera (arthroscope) to guide the procedure. The surgeon inserts specialized instruments through additional small incisions to repair the labrum and address any associated soft tissue damage.
Bankart repair is often accompanied by other procedures, depending on the specific condition of the patient's shoulder. These additional procedures may include addressing any capsular laxity (loose ligaments) or addressing other associated injuries such as Hill-Sachs lesions (compression fractures on the humeral head).
Following the surgery, a period of rehabilitation and physical therapy is usually required to restore strength, range of motion, and stability to the shoulder joint. The length and intensity of the rehabilitation process will vary depending on the individual and the extent of the initial injury.
Bankart repair is considered a successful surgical intervention for anterior shoulder instability, with a high rate of returning patients to their pre-injury level of activity and reducing the risk of recurrent dislocations. However, the success of the surgery can depend on various factors, including the severity of the initial injury, patient compliance with rehabilitation, and the surgeon's skill and experience.
It is important for individuals considering Bankart repair or any surgical procedure to consult with an orthopedic surgeon who can provide a thorough evaluation and determine the most appropriate treatment plan based on their specific condition.
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