Clinical Efficacy Of Arthroscopic High-strength Suture Through Humeral Head Tunnels Instead Of Anchor For Hill-Sachs Injury

Objective:To describe a therapy of the Remplissage technique for shoulder Hill-Sachs lesion by holding a high-strength suture through the bone tunnel of humeral head under arthroscope instead of by using anchors,in order to avoid the risk of filling failure resulting from anchor falling-off.Materials and Methods:From October 2013 to December 2017,158 patients with recurrent anterior dislocation of shoulder joints underwent arthroscopic surgery in our hospital and group hospital.Three patients underwent Larterjet operation,11 patients underwent bone graft fixation or fresh dislocation with bone defect removed,and 61 patients aged 18-45 years with similar labor intensity and exercise level were selected.The patients were divided into two groups according to the operation method.Group A consisted of 32 patients treated with Remplissage with wire anchor.Group B was an innovative surgical method group,and 29 cases in Remplissage group were treated with high strength suture through the humeral head canal.All patients were operated by a team led by the same physician,and complete follow-up data were obtained in 12 months after operation.Sample consistency test was carried out to confirm that there was no difference between the two groups.The stability of shoulder and shoulder mobility of patients at 12 months after operation were tested,and shoulder joint function score was made.Results:All patients were followed up for 12 months.No re-dislocation occurred during the follow-up period in both groups.MR showed that the posterior infraspinatus filling was good in all patients 12 months after operation.Statistical analysis showed that there was no significant difference in the score between the two groups(p=0.674 OSIS score,p=0.192 Rowe score).There was no significant difference in the increase angle of abduction and external rotation between the two groups before and after operation.Conclusions:Treatment of Hill-Sachs lesion of the shoulder by undergoing Remplissage procedure by using high-strength sutures through the bone tunnels of head of the humerus under arthroscopic monitoring has the benefits of secure fixing and elimination of the risk of anchor falling-off.Compared with the traditional treatment of recurrent anterior dislocation of shoulder with wire anchor,there is no significant difference.Meanwhile,because of the small diameter of bone canal,there are more opportunities to choose the location,which can increase the contact area between filling tissue and bone,and the healing reliability is better.