{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T07:08:04Z","timestamp":1784185684275,"version":"3.55.0"},"reference-count":57,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Sports Med"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Remplissage decreases recurrence after arthroscopic Bankart repair for anterior shoulder instability but has historically been reserved for off-track Hill-Sachs lesions. The addition of remplissage for patients with on-track lesions remains controversial because of concerns about added operative costs and potential loss of range of motion. The cost-effectiveness of remplissage in patients with on-track Hill-Sachs lesions has not been established.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To evaluate the cost-effectiveness of arthroscopic Bankart repair with remplissage versus isolated Bankart repair in patients with on-track Hill-Sachs lesions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Economic decision analysis; Level of evidence, 3.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A Markov decision model simulated a 10-year period from a societal perspective. There were 2 treatment strategies compared: isolated arthroscopic Bankart repair (IBR) and arthroscopic Bankart repair with remplissage (BR+R). Health states included stable shoulder, recurrent instability, stable shoulder after revision, and persistent instability. Transition probabilities were derived from random-effects meta-analysis of recurrence rates at a median 34.7-month follow-up. Costs (in 2025 United States dollars) included direct medical costs and indirect costs related to productivity loss. Costs and quality-adjusted life-years (QALYs) were discounted at 3% annually. Outcomes included total costs, QALYs, net monetary benefit (NMB), and incremental cost-effectiveness ratios (ICERs). Probabilistic sensitivity analysis (PSA) with Monte Carlo microsimulation was conducted with 1000 simulated patients and 10,000 PSA iterations. One-way sensitivity analysis evaluated the influence of individual parameters. Cost-effectiveness acceptability curves were generated at willingness-to-pay (WTP) thresholds of $50,000\/QALY and $100,000\/QALY.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Over a 10-year time horizon, BR+R yielded 8.59 QALYs at a cost of $24,980, whereas IBR yielded 8.18 QALYs at a cost of $23,333. BR+R was cost-effective in 99.89% and 99.99% of simulations at WTP thresholds of $50,000\/QALY and $100,000\/QALY, respectively. One-way sensitivity analysis showed that the model was most sensitive to recurrence probabilities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>For patients with on-track Hill-Sachs lesions and subcritical glenoid bone loss, Bankart repair with remplissage was cost-effective compared with isolated Bankart repair, driven by reductions in recurrence and revision surgery. These findings support the consideration of remplissage in patients with on-track lesions, particularly those at a higher risk for recurrence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03635465261444008","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T08:53:47Z","timestamp":1780304027000},"page":"2232-2243","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Cost-effectiveness of Adding Remplissage to Bankart Repair for On-track Hill-Sachs Lesions: A Markov Decision Analysis"],"prefix":"10.1177","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9783-3604","authenticated-orcid":false,"given":"Matthew","family":"Frederickson","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, University of California, Davis, Sacramento, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Kou","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of California, Davis, Sacramento, California, USA"},{"name":"College of Medicine, California Northstate University, Elk Grove, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7554-489X","authenticated-orcid":false,"given":"Dylan","family":"Cullinane","sequence":"additional","affiliation":[{"name":"University of California, Los Angeles, Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariano E.","family":"Menendez","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of California, Davis, Sacramento, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,1]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2018.10.117"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-014-3092-4"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/03635465221128913"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.2165\/00019053-199813040-00003"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X12458348"},{"key":"e_1_3_2_7_2","unstructured":"Bureau of Labor Statistics. 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