Ultrasound-Assisted Arthroscopic Remplissage

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Medical Imaging

Background:

• Recurrent anterior shoulder dislocation with engaging Hill-Sachs lesions has high recurrence rates after Bankart repair alone.
• Remplissage is an adjunct technique using infraspinatus and teres minor to enhance stability.
• Traditional remplissage is technically demanding, requiring precise anatomical identification.

Purpose of the Study:

• To describe a novel ultrasound-assisted arthroscopic remplissage technique.
• To enhance procedural accuracy and safety in treating shoulder instability.
• To provide guidance for surgeons, particularly less experienced ones.

Main Methods:

• Intraoperative ultrasound is used to identify key anatomical structures (infraspinatus, teres minor, Hill-Sachs lesion).
• Percutaneous needle placement and anchor insertion are guided by real-time ultrasound visualization.
• The double-pulley technique is employed for accurate fixation, optimizing tissue compression and stability.

Main Results:

• Ultrasound facilitates precise identification of soft tissues and lesions.
• Real-time guidance improves needle and anchor placement accuracy.
• The technique enhances soft tissue visualization, portal placement safety, and anchor orientation.

Conclusions:

• Ultrasound-assisted arthroscopic remplissage offers a safer and more effective alternative for recurrent shoulder instability with engaging Hill-Sachs lesions.
• This technique improves procedural accuracy and surgeon confidence.
• It represents a valuable advancement in managing complex shoulder instability cases.