The Role of Rotator Interval Closure in Arthroscopic Shoulder Instability Repair: A Prospective Randomized Study

Purpose: Arthroscopic Bankart repair (ABR) provides satisfactory results for recurrent anterior shoulder instability, but the high recurrence rates post-ABR remain a concern. One of the adjunct procedures proposed to improve SBR results is arthroscopic rotator interval closure (ARIC). This study prospectively evaluated the outcomes of ABRs alone compared to combined ABR+ARIC and identified risk factors related to failure of each procedure.

Methods: Thirty-nine consecutive patients (mean age 23.1 (18.3-37.5) years; 37 males) underwent arthroscopic stabilization for recurrent anterior traumatic shoulder instability. Twenty patients underwent ABR alone and 19 underwent ABR+ARIC. Remplissage was added when glenoid engagement was observed during surgery. All patients were prospectively followed, and their postoperative courses were reviewed and functionally assessed at the last visit.

Results: The re-dislocation rate was higher in the ABR+ARIC group compared to the ABR only group at a mean follow-up of 4.2 (2-5.6) years (3 Vs. 0, P = .06). More subluxations were found in the ABR only group (2 Vs. 1, respectively; P = .58). The final limitation of range of motion (ROM) compared with the preoperative ROM was similar in both groups. Remplissage procedures were performed more often in the ABR only group [12 (60%) Vs. 4 (21%), P = .013].

Conclusions: ARIC performed as an adjunct to ABR showed no superiority in attaining value-added stability compared to ABR alone. Adding a remplissage procedure may achieve better stability.