Arthroscopic Remplissage for Anterior Shoulder Instability

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Shoulder Instability Research

Background:

• Recurrent glenohumeral instability can be treated with Bankart repair, Latarjet, or Remplissage procedures.
• A Hill-Sachs lesion, history of recurrent dislocations, and young patient age are key indications for specific surgical interventions.

Purpose of the Study:

• To describe the technique and outcomes of augmenting an arthroscopic Bankart repair with a Remplissage procedure.
• To evaluate the efficacy of this combined approach in a young patient with a Hill-Sachs lesion and recurrent shoulder instability.

Main Methods:

• The procedure involved establishing four arthroscopic portals for surgical access.
• A Hill-Sachs lesion was addressed, and two anchors were placed for repair.
• The Remplissage was completed by repairing the infraspinatus tendon and capsule to the posterior humeral head.

Main Results:

• The Remplissage procedure, when combined with arthroscopic Bankart repair, demonstrates high success rates in reducing recurrent instability.
• Studies report very low recurrence rates (even 0%) and high return-to-sport rates (80-90%) post-surgery.
• Excellent short- to mid-term patient-reported outcomes and lower complication rates compared to Bankart repair alone have been documented.

Conclusions:

• The Remplissage procedure combined with Bankart repair is a safe and effective treatment for recurrent shoulder dislocations.
• This surgical approach enables patients to return to their previous activity levels, including sports.
• The combined technique offers a favorable option for young, active patients suffering from shoulder instability.