• ‘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. Alkhatib 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.