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Arthroscopic Remplissage Using a Double-Pulley Technique.

Cody Ashy1, Paul Pottanat1, Harris Slone1

  • 1Department of Orthopaedics, Medical University of South Carolina, Charleston, South Carolina, USA.

Video Journal of Sports Medicine
|May 1, 2025
PubMed
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This study presents a double-anchor-pulley technique for arthroscopic Remplissage to treat engaging Hill-Sachs lesions causing recurrent shoulder instability. The method shows excellent results with a low failure rate and high return to play.

Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Arthroscopy

Background:

  • Anterior shoulder instability frequently involves Hill-Sachs lesions (HSLs), with engaging HSLs leading to a 75% recurrence rate if unaddressed.
  • Remplissage is an established technique for managing recurrent instability associated with engaging HSLs.

Purpose of the Study:

  • To demonstrate a double-anchor-pulley technique for all-arthroscopic Remplissage in patients with recurrent anterior shoulder instability and engaging HSLs.
  • To provide a simple and reproducible surgical method for addressing engaging HSLs.

Main Methods:

  • The procedure involves arthroscopic preparation of the HSL defect using curettage and a bur.
  • Two knotless, all-suture anchors are placed and linked to create a broad compression repair.
Keywords:
Hill-Sachs lesionRemplissageanterior shoulder instabilityarthroscopic

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  • Bankart stabilization is performed concurrently.

    • Main Results:

    • The technique demonstrated excellent outcomes with a low failure rate of 5.6%.
    • Patients experienced significant improvement, a low complication rate, and a 95.5% return to play rate.

    Conclusions:

    • The double-anchor-pulley technique for arthroscopic Remplissage offers a reliable and reproducible solution for recurrent anterior shoulder instability caused by engaging HSLs.
    • This method achieves high success rates and facilitates a rapid return to athletic activities.