Abstract

After primary Bankart repair, recurrent shoulder instability occurs in up to 20% of the patients. Untreated bone defects, such as Hill Sachs lesions, may play an important role in the etiology of postoperative recurrence, especially when large and engaging defects are present. Remplissage (infraspinatus tenodesis and posterior capsulodesis) is an arthroscopic technique that "fills" the Hill Sachs defect, preventing its engagement on the glenoid, and thereby decreasing the possibility of postoperative subluxation or dislocation. Objective: We present an arthroscopic all intraarticular technique for the treatment of Hill Sachs defects in patients with anterior shoulder instability. Conclusion: The all intraarticular Remplissage technique is a reproducible procedure for the treatment of large engaging Hill Sachs defects in patients with anterior shoulder instability. The surgery is followed by a standard Bankart repair rehabilitation protocol. No further decrease in shoulder range of motion has been observed after this procedure. © 2008 Lippincott Williams & Wilkins.