No difference in outcomes after remplissage or open Bankart repair plus inferior capsular shift in collision and contact athletes with subcritical glenoid bone loss ≤ 10 % and off-track Hill Sachs lesion

To compare functional outcomes, recurrence rate, range of motion (ROM) and return to sport between arthroscopic Bankart repair with remplissage (BR) and open Bankart repair with inferior capsular shift (OBICS) in contact and collision athletes with recurrent anterior shoulder instability. A prospective comparative cohort study of 90 patients separated into two study groups (OBICS and BR) of 45 collision and contact athletes each was conducted. All athletes had subcritical glenoid bone loss (SGBL) ≤ 10% and off-track Hill Sach lesions (HSLs). A minimum follow-up period of 5 years was established. Pre- and post-operative assessments of each group, as well as between them, were carried out. The Western Ontario Shoulder Instability Index score (WOSI) and the American Shoulder and Elbow Surgeons (ASES) scale were used to assess subjective outcomes. Recurrence rate, ROM and return to sport were evaluated as objective outcomes. Significant differences were reported in the WOSI and ASES scores between preoperative and postoperative values in each group. There were no significant differences between the two groups (P = 0.68 and 0.28).Patient rates achieving MCID and PASS for ASES were 81.2% OBICS, 80% BR and 78.6% and 76.5% respectively. Although there was no significant difference between the two groups (P = 0.74), there were 3 dislocations (7.5%) in the OBICS group and 5 (12.5%) in the BR group. No significant differences in ROM were found between the two groups. However, significant differences in external rotation were reported in the BR group between pre- and post-operative (P = 0.03 and 0.04). We found no differences between the outcomes of the two groups. Depending on surgeon preference, BR or OBICS may be safely indicated in collision or contact athletes with SGBL ≤ 10% and off-track HSLs. Level II, prospective comparative study.