PDF(Pubmed)
Abstract：
OBJECTIVE: Arthroscopic remplissage has continued to gain popularity as an adjunct to Bankart repair for patients with anterior shoulder instability. Although the original remplissage technique was described over 15 years ago, our understanding of when and how to use this procedure continues to evolve. This article provides a review of how remplissage affects shoulder biomechanics, compares clinical outcomes between remplissage and other procedures for shoulder instability, and discusses current indications for remplissage.
RESULTS: Current research focuses on the use of remplissage across a wide range of glenoid bone loss. Remplissage appears effective at preventing recurrent instability in patients with glenoid bone loss up to 15% of the glenoid width. However, once glenoid bone exceeds 15%, outcomes tend to favor bony reconstruction procedures such as Latarjet. Results of biomechanical studies examining shoulder range of motion (ROM) after remplissage are mixed, though clinical studies tend to report no significant limitations in ROM when remplissage is added to a Bankart repair. Adding a remplissage to conventional Bankart repair may improve clinical outcomes and lower rates of recurrent instability without significantly altering shoulder ROM. However, surgeons should recognize its limitations in treating patients with large amounts of glenoid bone loss and should be prepared to discuss alternative procedures on a case-by-case basis. Absolute indications and contraindications for remplissage are not well defined currently and require further scientific research.
RESULTS: Current research focuses on the use of remplissage across a wide range of glenoid bone loss. Remplissage appears effective at preventing recurrent instability in patients with glenoid bone loss up to 15% of the glenoid width. However, once glenoid bone exceeds 15%, outcomes tend to favor bony reconstruction procedures such as Latarjet. Results of biomechanical studies examining shoulder range of motion (ROM) after remplissage are mixed, though clinical studies tend to report no significant limitations in ROM when remplissage is added to a Bankart repair. Adding a remplissage to conventional Bankart repair may improve clinical outcomes and lower rates of recurrent instability without significantly altering shoulder ROM. However, surgeons should recognize its limitations in treating patients with large amounts of glenoid bone loss and should be prepared to discuss alternative procedures on a case-by-case basis. Absolute indications and contraindications for remplissage are not well defined currently and require further scientific research.
摘要：
目的：关节镜保留作为Bankart修复肩关节前不稳定患者的辅助治疗方法一直很受欢迎。尽管最初的remplissage技术在15年前就已经描述过了，我们对何时以及如何使用此程序的理解不断发展。本文提供了remplissage如何影响肩部生物力学的综述，比较肩关节不稳和其他手术之间的临床结果，并讨论了目前的症状。
结果：目前的研究集中在广泛范围的关节盂骨丢失中使用红花。Remplissage似乎可有效预防关节盂骨丢失高达关节盂宽度的15％的患者的复发性不稳定。然而,一旦关节盂骨超过15%，结果倾向于支持骨重建程序，如Latarjet。混合后检查肩关节活动范围（ROM）的生物力学研究结果，尽管临床研究倾向于报告在Bankart修复中添加remplissage时ROM没有显着限制。在常规Bankart修复术中添加replissage可以改善临床结果并降低复发性不稳定的发生率，而不会显着改变肩部ROM。然而,外科医生应认识到其在治疗大量关节盂骨丢失患者方面的局限性，并应准备根据具体情况讨论替代手术。目前还没有很好地定义replissage的绝对适应症和禁忌症，需要进一步的科学研究。
结果：目前的研究集中在广泛范围的关节盂骨丢失中使用红花。Remplissage似乎可有效预防关节盂骨丢失高达关节盂宽度的15％的患者的复发性不稳定。然而,一旦关节盂骨超过15%，结果倾向于支持骨重建程序，如Latarjet。混合后检查肩关节活动范围（ROM）的生物力学研究结果，尽管临床研究倾向于报告在Bankart修复中添加remplissage时ROM没有显着限制。在常规Bankart修复术中添加replissage可以改善临床结果并降低复发性不稳定的发生率，而不会显着改变肩部ROM。然而,外科医生应认识到其在治疗大量关节盂骨丢失患者方面的局限性，并应准备根据具体情况讨论替代手术。目前还没有很好地定义replissage的绝对适应症和禁忌症，需要进一步的科学研究。
