Dr. Chen's Technique for Remplissage:
An arthroscopic procedure performed to stabilize the shoulder after a dislocation or injury has caused tearing of the anterior labrum with a large divot in the humeral head (Hill-Sachs defect). Remplissage is a French term that means "To Fill the Defect". Thus in this procedure an additional pair of anchors are placed into the Hill-Sachs lesion and the infraspinatus rotator cuff tendon is repaired into the defect to fill the defect. This serves as a checkrein to prevent any further anterior instability. Typically a Remplissage is performed when a patient has failed previous shoulder stabilization surgeries or there is a large and/or engaging Hill-Sachs defect.
FEATURED IN ARTHROSCOPY TECHNIQUES
Dr. Chen's surgical technique for arthroscopic remplissage using a double-pulley system for Hill-Sachs lesions for recurrent instability has been featured in Arthroscopy Techniques - The Journal of Arthroscopic and Related Surgery.
Common Questions about Anterior Shoulder Stabilization with Remplissage
What is a Remplissage?
Remplissage is a French term that means “filling the defect”. In shoulder stabilization surgery a Remplissage fills a humeral defect called a Hill-Sachs defect that is created when the humeral head hits the edge of the socket. In a Remplissage, the posterior rotator cuff is used to fill the defect.
How is a Remplissage performed?
Remplissage is performed by placing suture anchors into the humeral head defect. The posterior rotator cuff is then tied into the defect with the sutures. This fills the defect and creates a posterior harness that prevents further anterior shoulder instability
What are the restrictions after Remplissage?
In general patients return to full activity without restrictions. Some shoulder external rotation can be lost from the remplissage procedure. However, this is due to the rotator cuff harnessing the ball and preventing it from dislocating from the socket.
When should a Remplissage be performed?
Remplissage may be appropriate when a patient has recurrent shoulder instability, failed prior stabilization surgery with minimal healthy labrum to repair, or for a patient with a large humeral head defect (Hill-Sachs defect).