Effect of artroscopic remplissage procedure on shoulder joint range of motion in patients with anterior shoulder instability

Purpose: Whether or not the range of motion is affected in patients undergoing arthroscopic Bankart repair (ABR) and additional remplissage procedure to arthroscopic Bankart repair remains a matter of debate. Based on these, in this study, we aimed to achieve whether the joint range of motion was affected in the post- operative period of the patients whom we applied the remplissage procedure in addition to ABR compared to the patients who received only ABO in our clinic, and to evaluate the functional results of these patients with a larger study group. Method: Between 2017-2021 at Ankara Atatürk Training and Research Hospital and Ankara City Hospital patients who underwent arthroscopic Bankart repair due to anterior shoulder instability and who underwent additional remplissage procedure to arthroscopic Bankart repair were included in the study. In the first year controls examination, measurement and scores recorded and documented in the patient files. Rowe scores, range of motion and demographic data of the patients in their first year controls were evaluated clinically. Results: A total of 60 shoulders of 60 patients, who had 30 isolated arthroscopic Bankart repairs and 30 arthroscopic Bankart repair in addition to remplissage procedure, were included in the study. The mean age of the patients in the study was 27.5±5.8 years; and 70% of the patients were male. Age and gender were not statistically different between the groups according to the procedures applied, and the groups were homogeneously distributed. In 1 of 30 patients who underwent isolated ABR, a re-dislocation of the operated shoulder occurred after falling from same level in the 2nd month postoperatively, and it was accepted as an unsuccessful result. Wound infection and skin problems did not occur in any of the 60 patients who were operated. In 3 of 30 patients, stiffness and pain around the posterolateral accessory port were present at the 1st year postoperative follow-up. External rotation measurements of the patients were statistically significantly different according to the groups. External rotation measurements of the patients in the Bankart + Remplissage group was statistically significantly lower. Patients whith isolated ABR had limited external rotation compared to the intact shoulder, but this difference was not statistically significant. There was no statistically significant difference between the internal rotation and Rowe scores between the groups according to the applied procedures. Conclusion: With the appropriate surgical indication, satisfactory clinical results can be obtained with the remplissage technique in addition to ABR. However, it has been a matter of debate whether there will be a decrease in the range of motion of the joint due to the tenodesis effect and the narrowing of the capsular volume after the additive remplissage procedure, and there is still no consensus on this issue. In our results, we found statistically significantly lower ranges of motion in external rotation, forward flexion and abduction in patients who underwent remplissage procedure in addition to ABR, when compared to patients who underwent isolated ABR. According to our results, we did not find a statistically significant difference between the two methods in the degree of internal rotation. Functionally, Rowe scores were examined in both procedures and we had good results in both procedures