Idea Transcript
Abstract Number: Paper 100 Abstract Title: Biomechanical Comparison of Acute Hill‐Sachs Reduction and Remplissage to Treat Complex Anterior Instability: The Potential Benefits of Anatomic Reconstruction Author Block: Joshua S. Dines, MD1, Grant Garcia, MD2, Michelle H. McGarry, MS3, Thay Q. Lee, PhD4, Ryan Degen, MD5. 1 Hospital for Special Surgery, Uniondale, NY, USA, 2Hospital for Special Surgery, New York City, NY, USA, 3 VA Healthcare System & University of California, Irvine, Long Beach, CA, USA, 4VA Healthcare System & University of California, Irvine, Long Beach, CA, USA, 5Hospital for Special Surgery/Cornell Medical Center Program, New York, NY, USA. Abstract: Objectives: Acute Hill‐Sachs (HS) reduction represents a potential alternative method to remplissage for the treatment of an engaging HS lesion. The purpose of this study is to biomechanically compare the stabilizing effects of a acute HS reduction technique and remplissage in a complex instability model. Methods: This was a comparative cadaveric study of 6 shoulders. For the acute HS lesion, a unique model was used to create a 30% defect, compressing the subchondral bone while preserving the articular surface in a more anatomic fashion. In addition, a 15% glenoid defect was made in all specimens. The HS lesion was reduced through a lateral cortical window with a bone tamp, and the subchondral void was filled with Quickset (Arthrex) bone cement to prevent plastic deformation. Five scenarios were tested; intact specimen, bipolar lesion, Bankart repair, remplissage with Bankart repair and HS reduction technique with Bankart repair. Translation, kinematics and dislocation events were recorded. Results: For all 6 specimens no dislocations occurred after either remplissage or the reduction technique. At 90 degrees of abduction and external rotation (ABER), anterior‐inferior translation was 11.1 mm (SD 0.9) for the bipolar lesion. This was significantly reduced following both remplissage (5.1±0.7mm; p