This case report describes the management of a failed arthroscopic anterior instability repair. It is the case of a 24-year-old man who had been operated for the first time 3.5 years earlier due to anterior instability of his right shoulder undergoing an arthroscopic Bankart repair. He completed successfully the rehabilitation program and returned to his daily activities. One year after the operation, he sustained a new dislocation of his right shoulder due to a low-energy trauma. After that, the patient had two more episodes of anterior dislocation, the last one during his sleep. He was a recreational athlete, playing basketball, but he had stopped any sporting activity due to recurrent instability of his right shoulder. This right-handed young man was reoperated arthroscopically, and a bone block procedure was performed, combined with remplissage. One year after the reoperation, he had full ROM and function of his shoulder, and he returned not only to his daily activities but also to his sporting activities.
In conclusion, in this case of failed Bankart repair with significant glenoid and humeral head bone loss, arthroscopic reconstruction of the anterior glenoid using autologous bone graft with concomitant soft-tissue reconstruction and remplissage had a good subjective (patient satisfaction) and objective (shoulder ROM and function) outcome at 1-year follow-up. The described procedure provided a suitable solution for the management of failed arthroscopic anterior instability repair.
Shoulder arthroscopy Recurrent anterior instability Engaging Hill–Sachs Bone block Remplissage
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