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Oregon Shoulder Institute

What is a Remplissage for shoulder dislocations?

Illustration of a shoulder dislocation showing a Hill-Sachs lesion on the humeral head.

A periodic review of scientific literature is important to ensure that the most up-to-date practices are used at the Oregon Shoulder Institute. In our review of the arthroscopic remplissage, a surgery aimed at treating shoulder instability, we investigate current trends, techniques, and indications of this evolving procedure.

What the procedure does

With repeated episodes of shoulder dislocation, an impression can form on the head of the humerus — the "ball" of the ball-and-socket shoulder joint. Bony lesions like this place the shoulder at an increased risk of dislocation.

The remplissage procedure addresses this issue by "filling in" the lesion with nearby rotator cuff tendon and shoulder joint capsule tissue. This acts as a restraint against shoulder dislocation by preventing the humeral head from catching and falling out of its socket.

When it is indicated

In general, it is the size of the lesion and amount of bone loss that dictates when a remplissage should be performed. However, certain patient characteristics like level of activity and hyperlaxity of the shoulder joint are also taken into account.

Many studies have demonstrated excellent clinical outcomes and healing rates with minimal postoperative loss in shoulder range of motion. Recent techniques have also been developed which increase the efficiency of the procedure and strengthen the tendon-to-bone attachment.

Our investigation found that the arthroscopic remplissage procedure is effective, when properly indicated, at stabilizing the shoulder joint and preventing recurrent episodes of shoulder dislocation.

Diagram of the remplissage procedure attaching rotator cuff tendon into the humeral head defect
Figure 1. The overall remplissage procedure. A rotator cuff tendon is attached into the compression fracture on the head of the humerus to stabilize the shoulder joint and prevent dislocation.

Read the published review.

Portrait of Dr. Patrick J. Denard, MD

About the author

Patrick J. Denard, MD

Dr. Denard is a shoulder surgeon at Oregon Shoulder Institute in Medford, Oregon. He is ranked #2 in North America for rotator cuff repair and #17 globally for shoulder replacement, has authored over 300 peer-reviewed publications, and performs over 400 shoulder surgeries annually.

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