This technical note introduces and names the arthroscopic remplissage procedure for treating shoulder instability with a large engaging Hill-Sachs lesion. The infraspinatus tendon and posterior capsule are sutured into the humeral head defect to fill it. It is performed alongside an arthroscopic Bankart repair to address bipolar bone loss.
When you see recurrent anterior instability with a large engaging Hill-Sachs lesion, an isolated arthroscopic Bankart repair is set up to fail. Burkhart and De Beer showed bony defects accounted for 67% of recurrences.
Remplissage answers a specific question: how do you neutralize the humeral-side defect arthroscopically without an open bone procedure? You fill it with infraspinatus and capsule, converting it to an extra-articular lesion that cannot engage. The decision rule: bipolar bone loss with an engaging Hill-Sachs means add remplissage to your Bankart repair rather than doing the labral repair alone.
Keep the evidence in perspective. This is a technical note with only unpublished early outcomes (2 of 24 recurrences). It introduced the term that now anchors a large body of shoulder instability literature, but the durable comparative data came later.
This technical note introduces and names the arthroscopic remplissage procedure for treating shoulder instability with a large engaging Hill-Sachs lesion. The infraspinatus tendon and posterior capsule are sutured into the humeral head defect to fill it. It is performed alongside an arthroscopic Bankart repair to address bipolar bone loss.
When you see recurrent anterior instability with a large engaging Hill-Sachs lesion, an isolated arthroscopic Bankart repair is set up to fail. Burkhart and De Beer showed bony defects accounted for 67% of recurrences.
Remplissage answers a specific question: how do you neutralize the humeral-side defect arthroscopically without an open bone procedure? You fill it with infraspinatus and capsule, converting it to an extra-articular lesion that cannot engage. The decision rule: bipolar bone loss with an engaging Hill-Sachs means add remplissage to your Bankart repair rather than doing the labral repair alone.
Keep the evidence in perspective. This is a technical note with only unpublished early outcomes (2 of 24 recurrences). It introduced the term that now anchors a large body of shoulder instability literature, but the durable comparative data came later.