Bankart Repair with and without Remplissage in Anterior Shoulder Instability


Anterior shoulder dislocation occurs when the head of the upper arm bone (humerus) is moved forward out of its socket.  Shoulder stabilization surgery is one option in managing this injury, to reduce the risk of re-dislocation.  When a shoulder dislocation occurs, many structures can be damaged.  One such structure is the bony head of the humerus which can be compressed or “dented”.  In cases such as this, an additional procedure, called a “Remplissage” was developed to ‘fill’ this dent with a tendon of one of the rotator cuff muscles.  Although thought to reduce re-dislocations, no study had been previously conducted to compare shoulder stabilization with and without Remplissage.  The Pan Am Clinic Research Team has undertaken a high level study to examine if the addition of this extra procedure is beneficial in reducing re-dislocation, and also if any drawbacks exist to its use.

This is a multi-centre trial for which Pan Am Clinic is the lead site, in collaboration with Ottawa Hospital.  One hundred and four patients, 80 from Pan Am Clinic, have now been recruited and evaluated before surgery and the outcome of their surgery was examined at 3-, 6-, 12-, and 24-months post-operative.  Measures included re-dislocation, range of movement in the shoulder, strength, and also documentation of how the patient feels they are doing with pain, movement, as well as their ability to perform tasks at work and in sport.

The outcome of this study will provide evidence to surgeons as to if Remplissage in shoulder stabilization surgery reduces the risk of re-dislocation.  It also allows the surgeon to weigh this risk against potential changes in strength and/or movement in the shoulder, both from an objective standpoint and from the patient’s own perspective.

Shoulder dislocation is a difficult injury to manage, with risk of recurrence even after stabilization surgery, being of great concern.  The outcome of this study has the potential to improve patients’ risk of re-injury if Remplissage is shown to be effective.

Surgeons: Dr. Peter MacDonald, Dr. Greg Stranges, Dr. Jamie Dubberley, Dr. Jason Old, Dr. Jon Marsh
Radiologist: Dr. James Koenig
Researchers: Dr. Sheila McRae, Brittany Bruinooge