CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2019; 54(01): 013-019
DOI: 10.1016/j.rbo.2017.10.010
Original Article | Artigo Original
Sociedade Brasileira de Ortopedia e Traumatologia. Published by Thieme Revnter Publicações Ltda Rio de Janeiro, Brazil

Clinical and Image Outcomes of the Hill-Sachs Injury Approach by the Remplissage Technique on the Anterior Shoulder Instability[*]

Article in several languages: português | English
1  Hospital Ortopédico, Belo Horizonte, MG, Brasil
2  Hospital Belvedere, Belo Horizonte, MG, Brasil
,
André Couto Godinho
1  Hospital Ortopédico, Belo Horizonte, MG, Brasil
2  Hospital Belvedere, Belo Horizonte, MG, Brasil
3  Hospital Belo Horizonte, Belo Horizonte, MG, Brasil
,
Diego Pedrosa Capitol Carneiro Leal
1  Hospital Ortopédico, Belo Horizonte, MG, Brasil
2  Hospital Belvedere, Belo Horizonte, MG, Brasil
,
Mateus Matos Mantovani
1  Hospital Ortopédico, Belo Horizonte, MG, Brasil
2  Hospital Belvedere, Belo Horizonte, MG, Brasil
,
Rafael Rodrigues Frazão
1  Hospital Ortopédico, Belo Horizonte, MG, Brasil
2  Hospital Belvedere, Belo Horizonte, MG, Brasil
,
Ricardo Ferreira Mariz
1  Hospital Ortopédico, Belo Horizonte, MG, Brasil
2  Hospital Belvedere, Belo Horizonte, MG, Brasil
› Author Affiliations
Further Information

Publication History

25 July 2017

24 October 2017

Publication Date:
01 March 2019 (online)

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.

* Work developed at the Hospital Ortopédico, Belo Horizonte, MG, Brazil.