Récupération fonctionnelle du muscle infra épineux après une intervention de Hill Sachs remplissage arthroscopique. Analyse Isocinétique et radiologique

Abstract : Introduction: The arthroscopic Hill Sachs Remplissage associated with a Bankart makes it possible to fill the humeral bone defect in glenohumeral instability surgery. Our hypothesis was that capsulo-tenodesis is an effective solution with good clinical results and no consequence on infraspinatus muscle function. Material and method: This was a case control retrospective study involving 22 patients operated with a Hill Sachs remplissage combined with an arthroscopic Bankart at 3 years of follow-up. The shoulder amplitudes were measured using a goniometer and compared to the contralateral healthy side. Constant, Rowe, Walch and Duplay and WOSI scores were calculated. An isokinetic evaluation of both shoulders was compared using a dynanometer in concentric, eccentric and endurance. The healing and fatty infiltration were analyzed by magnetic resonance imaging. Results: At last follow-up, 94.7% were satisfied. Amplitudes were decreased by 10.8 ° with the arm at the side of the trunk and 6 ° in abduction (p <0.05). Walch and Rowe average scores were 71.05 (40 to 90) and 67.63 (15 to 100). The average weighted constant score was 69.8 (62 to 100). The average total WOSI was 34.6%. An external rotator strength deficit was found in all isokinetic tests greater than 15% (p <0.03). On the postoperative MRI, all showed good capsulo-tenodesis healing without infraspinatus muscle fatty degeneration. Conclusion: The arthroscopic Hill-Sachs Remplissage associated with a Bankart is an effective solution in the treatment of anterior glenohumeral instability. Despite the absence of morphological modification of the infraspinatus, the strentgh recovery is not complete.
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Julie Falguieres. Récupération fonctionnelle du muscle infra épineux après une intervention de Hill Sachs remplissage arthroscopique. Analyse Isocinétique et radiologique. Sciences du Vivant [q-bio]. 2018. ⟨dumas-02089145⟩

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