Yang and colleagues compared arthroscopic Bankart repair with remplissage against the modified Latarjet in shoulders with an off‑track Hill‑Sachs lesion and glenoid bone loss below 25%.
Retrospective cohort of 189 patients (98 remplissage, 91 Latarjet) treated 2005 to 2015 at 2 centers, mean follow‑up 3.2 years (range 2 to 12).
The two procedures would give similar recurrence, revision and clinical outcomes.
Key Findings
Overall, recurrence did not differ significantly (13.3% after remplissage vs 5.49% after Latarjet, p = .085), nor did WOSI or SANE. The authors note the study may have been underpowered for recurrence.
Complications were more frequent after Latarjet (12.1% vs 1% after remplissage, p = .002).
In the subgroup with prior instability surgery, recurrence was 34.8% after remplissage vs 10.3% after Latarjet (p = .042), and revision 43.5% vs 15.4% (p = .019).
In the subgroup with over 15% glenoid bone loss, recurrence was 28.6% after remplissage vs 6.06% after Latarjet (p = .034). At 10% to 15% loss, the adjusted odds of recurrence were 1.28 times higher with remplissage (p = .04).
In collision and contact athletes, recurrence was 30% after remplissage and none after Latarjet (p = .005). WOSI was also better after Latarjet (138 vs 231, p = .019).
Surgeons chose the procedure by their own indications. The Latarjet group had more prior instability surgery (42.9% vs 23.5%, p = .005).
Authors' conclusion
For off-track Hill-Sachs lesions with subcritical glenoid bone loss, both the remplissage and modified Latarjet can achieve satisfactory results with the initial surgical intervention in the general population, but a higher complication rate was observed in the Latarjet group. However, Latarjet appears to be a better choice in patients with revision instability surgery, collision and contact athletes, and those with >10% glenoid bone loss.
Yang and colleagues compared arthroscopic Bankart repair with remplissage against the modified Latarjet in shoulders with an off‑track Hill‑Sachs lesion and glenoid bone loss below 25%.
Retrospective cohort of 189 patients (98 remplissage, 91 Latarjet) treated 2005 to 2015 at 2 centers, mean follow‑up 3.2 years (range 2 to 12).
The two procedures would give similar recurrence, revision and clinical outcomes.
Key Findings
Overall, recurrence did not differ significantly (13.3% after remplissage vs 5.49% after Latarjet, p = .085), nor did WOSI or SANE. The authors note the study may have been underpowered for recurrence.
Complications were more frequent after Latarjet (12.1% vs 1% after remplissage, p = .002).
In the subgroup with prior instability surgery, recurrence was 34.8% after remplissage vs 10.3% after Latarjet (p = .042), and revision 43.5% vs 15.4% (p = .019).
In the subgroup with over 15% glenoid bone loss, recurrence was 28.6% after remplissage vs 6.06% after Latarjet (p = .034). At 10% to 15% loss, the adjusted odds of recurrence were 1.28 times higher with remplissage (p = .04).
In collision and contact athletes, recurrence was 30% after remplissage and none after Latarjet (p = .005). WOSI was also better after Latarjet (138 vs 231, p = .019).
Surgeons chose the procedure by their own indications. The Latarjet group had more prior instability surgery (42.9% vs 23.5%, p = .005).
Authors' conclusion
For off-track Hill-Sachs lesions with subcritical glenoid bone loss, both the remplissage and modified Latarjet can achieve satisfactory results with the initial surgical intervention in the general population, but a higher complication rate was observed in the Latarjet group. However, Latarjet appears to be a better choice in patients with revision instability surgery, collision and contact athletes, and those with >10% glenoid bone loss.