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Injury conditions included 15% glenoid bone loss with an on\u2010track or off\u2010track Hill\u2013Sachs lesion as previously recommended. Repair conditions included isolated BR, BR with remplissage, and BR with DAS (long head of biceps transfer). The glenohumeral stability was assessed by measuring the anterior translation under 0, 10, 20, 30, 40, 50 N load and maximum load without causing instability at mid\u2010range (60\u00b0) and end\u2010range (90\u00b0) external rotation (ER). Maximum range of motion (ROM) was measured by applying a 2.2\u2010N\u00b7m torque in passive ER and internal rotation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Isolated BR failed to restore native glenohumeral stability in both on\u2010track and off\u2010track bipolar bone loss models. Both remplissage and DAS significantly decreased the anterior instability in the bipolar bone loss models, showing better restoration than the isolated BR. In the on\u2010track lesions, DAS successfully restored native glenohumeral stability and mobility, whereas remplissage significantly decreased anterior translation without load (\u20132.12 \u00b1 1.07 mm at 90\u00b0 ER,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .003; \u20131.98 \u00b1 1.23 mm at 60\u00b0 ER,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .015). In the off\u2010track lesions, remplissage restored native glenohumeral stability but led to significant ROM limitation (\u20138.6\u00b0 \u00b1 2.3\u00b0 for internal rotation,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001; \u201313.9\u00b0 \u00b1 6.2\u00b0 for ER,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .003), whereas DAS failed to restore native stability at 90\u00b0 ER regarding the increased anterior translation under 50 N (4.10 \u00b1 1.53 mm,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001) and decreased maximum load (\u201313.8 \u00b1 9.2 N,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .021).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>At time\u2010zero, both remplissage and DAS significantly reduced residual anterior instability compared with isolated BR in the bipolar bone loss models and restored the native glenohumeral stability under most translational loads. However, remplissage could decrease the anterior translation without load for on\u2010track lesions and may restrict ROM for off\u2010track lesions, whereas DAS failed to restore native stability under high translational loads for off\u2010track lesions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance<\/jats:title>\n                    <jats:p>DAS could be recommended to treat on\u2010track bipolar bone loss with less biomechanical adverse effects, whereas remplissage might be the preferred procedure to address off\u2010track bipolar bone loss for better stability.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2024.01.023","type":"journal-article","created":{"date-parts":[[2024,2,2]],"date-time":"2024-02-02T06:43:58Z","timestamp":1706856238000},"page":"1982-1993","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":19,"title":["Biomechanical Analysis Reveals Shoulder Instability With Bipolar Bone Loss Is Best Treated With Dynamic Anterior Stabilization for On\u2010Track Lesions and With Remplissage for Off\u2010Track Lesions"],"prefix":"10.1002","volume":"40","author":[{"given":"Chenliang","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Sports Medicine Shanghai Sixth People\u2019s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zipeng","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine Shanghai Sixth People\u2019s Hospital 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