Background: Recurrent anterior shoulder instability with glenoid bone loss remains a surgical challenge.The Latarjet procedure has shown reliable results, yet controversy persists regarding the role of adding remplissage.While some studies suggest it may improve stability in cases with concomitant Hill-Sachs lesions, others report no clear functional advantage and potential restriction of external rotation.Purpose: To compare the clinical outcomes of the modified Latarjet procedure versus the modified Latarjet with remplissage.Methods: A prospective randomized, single-blinded trial was conducted from 2016 to 2019, enrolling 60 patients with recurrent anterior shoulder instability, glenoid bone loss >25%, and off-track Hill-Sachs lesions.Patients were randomized to modified Latarjet alone (n=30) or Latarjet plus remplissage (n=30).Outcome assessors were blinded, and follow-up was 24 months.Evaluations included ROM, Rowe, Oxford, Constant scores, VAS pain, satisfaction, return to activity, and complications.Results: After 2 years, all clinical outcomes had improved significantly in both groups (p<0.01), with no significant differences between groups.Mean Rowe: 85.6721.16vs 85.1717.83(p=0.92);VAS: 2.931.86vs 2.731.33(p=0.63);Constant: 84.3612.69vs 86.5611.41(p=0.48);Oxford: 38.709.02vs 40.369.03(p=0.47).Return to pre-injury activity: 25/30 vs 26/30 (p=0.72).External rotation loss J o u r n a l P r e -p r o o f was greater in Group 2 (12.471.67vs 25.676.0,p<0.01).Operative time was longer in Group 2 (60.7112.8vs 86.512.7 minutes, p<0.001). Conclusion:Both techniques provided significant and comparable clinical improvement.The addition of remplissage was associated with more postoperative limitation of external rotation and longer operative times.
Abd-Elzaher et al. (Sun,) studied this question.