Remplissage is an arthroscopic stabilization technique commonly associated with the treatment of recurrent anterior shoulder instability when a clinically relevant Hill-Sachs lesion is present. The procedure is generally performed together with anterior capsulolabral stabilization, such as Bankart repair, when indicated.
The term “remplissage” means “filling” in French. In this procedure, the posterior capsule and infraspinatus tendon are fixed into the Hill-Sachs defect, reducing the tendency of the humeral head defect to engage with the anterior glenoid rim.
A Hill-Sachs lesion is a compression defect of the posterolateral humeral head that can occur during anterior shoulder dislocation. Its clinical importance depends on factors such as the size, location and relationship of the defect to the glenoid.
When the lesion contributes to engagement or instability, additional stabilization procedures may be considered alongside repair of the anterior capsulolabral structures.
During arthroscopic remplissage, suture anchors are placed into the Hill-Sachs defect of the humeral head. Sutures from the anchors are passed through the posterior capsule and infraspinatus tendon.
The sutures are then secured to approximate these tissues to the defect, effectively filling the defect with posterior soft tissue and helping reduce engagement of the humeral head with the glenoid rim.
Depending on the selected technique and fixation strategy, different suture anchor configurations and materials may be used.
Suture anchors provide the fixation point between the humeral head and the posterior soft tissues. Important considerations may include:
Smaller-diameter anchors and all-suture anchors may be considered when minimizing the size of the bone tunnel is desirable, while conventional titanium or PEEK anchor systems provide alternative fixation configurations.
ORTHOSYN provides different suture anchor systems for arthroscopic soft tissue-to-bone fixation, including:
Different materials, diameters and fixation mechanisms allow the appropriate anchor configuration to be selected according to the surgical technique and procedural requirements.
For more information about ORTHOSYN anchor systems, visit the ORTHOSYN Anchors product category.