Remplissage

‘Remplissage’ is French for ‘to fill in’.
The procedure is an adjunct to the arthroscopic anterior stabilisation procedure of the shoulder in order to address bone deficiency associated with shoulder instability.

This technique is performed when the Hill-Sachs lesion is very large and ‘engaging’ the anterior glenoid with little overhead movement (i.e. dislocating very easily due to the large Hill-Sachs lesion, as well as the Bankart lesion). In these situations a Bankart repair alone may not be sufficient. Thus the development of the remplissage technique.

Dr. Ahmad has been performing the Remplissage procedure for more than 10 years.
Many of his patients who have undergone the remplissage procedure play high level sports and have returned to the same level with tremendous satisfaction.

The arthroscope is placed through the anterior portal to view the Hill-Sach’s lesion on the posterior aspect of the humeral head. Through the posterior portal, instruments abrade the bone of the Hill-Sach’s lesion to stimulate healing. A double-loaded small rotator cuff anchor is inserted into the Hill-Sach’s lesion through the posterior portal. Sutures are passed through the infraspinatus tendon and capsule. The sutures for the Remplissage are tied after addressing the Bankart lesion.

Advantages of the Remplissage technique includes the ability to manage mild forms of bone deficiency associated with shoulder dislocations. Bone deficiency that goes unmanaged can cause failure of the surgery.