Arthroscopic Remplissage for the Treatment of Anterior Shoulder Instability: Current and Evolving Concepts

JBJS Rev. 2022 Nov 2;10(11). doi: 10.2106/JBJS.RVW.22.00151. eCollection 2022 Nov 1.

Abstract

➢: A Hill-Sachs lesion (HSL) is a compression fracture on the posterolateral humeral head that can increase the risk of recurrent shoulder instability after isolated arthroscopic Bankart repair.

➢: Remplissage involves capsulotenodesis of the infraspinatus tendon and posterior capsule into the HSL to prevent its engagement with the glenoid rim through extra-articular conversion and restraint against humeral head anterior translation.

➢: The glenoid track concept can be applied preoperatively and intraoperatively to evaluate risk of recurrence and help direct clinical management options for recurrent shoulder instability.

➢: Recent literature supports expanding indications for remplissage to include patients with on-track HSLs who are at increased risk of recurrence including collision athletes, military personal, and patients with joint hyperlaxity.

➢: New techniques and suture constructs have demonstrated improved biomechanical strength while avoiding the need to access the subacromial space.

MeSH terms

  • Bankart Lesions* / surgery
  • Humans
  • Joint Instability* / surgery
  • Shoulder
  • Shoulder Dislocation* / surgery
  • Shoulder Joint* / surgery