Arthroscopic Rotator Cuff Remplissage Technique to Limit Soft Tissue Interposition

Anterior shoulder instability is commonly associated with Hill-Sachs lesions and subcritical glenoid bone loss. In patients with an off-track pattern, arthroscopic Bankart repair augmented with the Remplissage procedure has been shown to reduce recurrent instability. However, conventional Remplissage techniques often require blind suture retrieval in the subacromial space, which may be time-consuming and increase the risk of soft tissue interposition. This technical note presents a simplified arthroscopic Remplissage technique that enables direct visualization and retrieval of all suture limbs through a single posterior portal and a guided lateral accessory portal. By maintaining precise cannula positioning and direct visualization of suture management throughout the procedure, this technique minimizes soft tissue interposition, preserves deltoid integrity, and streamlines the operative workflow, thereby reducing overall operative time.