Hill-Sachs Remplissage Procedure Based on Posterosuperior Capsulomuscular Anatomy

Abstract

The remplissage technique is a procedure designed to fill a posterosuperior humeral head defect with the infraspinatus tendon and posterior-superior capsule in patients with engaging Hill-Sachs lesions. We describe a remplissage technique using 2 posterior working portals that respects the anatomy of the posterior-superior area of the glenohumeral joint without compromising the vascularization.

Arthroscopic Bankart and Remplissage for Anteroinferior Instability With Subcritical Bone Loss Has a Low Recurrence Rate

“…Thus, the remplissage procedure does not cause any clinically significant loss of external rotation, although some studies continue to express contrasting reports. 28,38 Pain in the posterosuperior region of the shoulder was experienced by 2 patients (8.33%) postoperatively, which is in accordance with certain studies. 31,32 This posterosuperior pain was felt more during forceful movements of the shoulder or when tired.…”

“…[21][22][23][24]34 Theoretical loss of external rotation after surgery is cited as one of the main drawbacks of the remplissage procedure. 22,[27][28][29] A statistically significant loss of external rotation was described by Deutsch and Kroll 37 in their study. In our study postoperatively 25% (n ¼ 6) had reduced external rotation.…”

“…11,17,[21][22][23][24] The main cited drawback of remplissage is the decrease in external rotation due to the infraspinatus tendon being tethered in a nonanatomic location. 11,22,[27][28][29] Pain, mainly in the posterosuperior region of the shoulder, is also a potential drawback of the remplissage procedure. 24,[30][31][32] The purpose of our study is to demonstrate whether arthroscopic remplissage can achieve good outcomes without significantly impairing shoulder function.…”

Modified Dynamic Anterior Stabilization (DAS) and Hill-Sachs Remplissage for the Treatment of Recurrent Anterior Shoulder Dislocation

“…When confronted with recurrent anterior shoulder instability, treatment options depend on the defect size of the glenoid and of the humeral head. 3,14,15 So far, soft tissue stabilization procedures (labral reinsertion, 1 remplissage techniques 13 ) and bone augmentation techniques (Latarjet, Eden-Hybinette 16 ) have been shown to be effective if their indication respects the demonstrated threshold related to off-track/on-track measurements of the bipolar lesion. 2,4,14,17 However, each technique has specific limitations.…”