Arthroscopic Remplissage for the Treatment of Anterior Shoulder Instability: Current and Evolving Concepts. Issue 11 (2nd November 2022)

• Record Type: Journal Article
• Authors: Hwang, Simon T.; Horinek, Jeffrey L.; Ardebol, Javier; Menendez, Mariano E.; Denard, Patrick J.
• Is Part Of: JBJS reviews. Volume 10:Issue 11(2022)
• Publication Date: 2022-11-02
• Subjects: Bones -- Surgery -- Periodicals; Joints -- Surgery -- Periodicals; Orthopedics -- Periodicals; Orthopedics; General Surgery; Bone Diseases; Joint Diseases; Bones -- Surgery; Joints -- Surgery; Orthopedics; Periodicals; Electronic journals; Periodicals; 617.47
• DOI: 10.2106/JBJS.RVW.22.00151
• Languages: English
• ISSNs: 2329-9185

Abstract

Abstract : ➢ A Hill-Sachs lesion (HSL) is a compression fracture on the posterolateral humeral head that can increase the risk of recurrent shoulder instability after isolated arthroscopic Bankart repair. ➢ Remplissage involves capsulotenodesis of the infraspinatus tendon and posterior capsule into the HSL to prevent its engagement with the glenoid rim through extra-articular conversion and restraint against humeral head anterior translation. ➢ The glenoid track concept can be applied preoperatively and intraoperatively to evaluate risk of recurrence and help direct clinical management options for recurrent shoulder instability. ➢ Recent literature supports expanding indications for remplissage to include patients with on-track HSLs who are at increased risk of recurrence including collision athletes, military personal, and patients with joint hyperlaxity. ➢ New techniques and suture constructs have demonstrated improved biomechanical strength while avoiding the need to access the subacromial space.