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. 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.
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.
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Figure 1. Image demonstrating 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 dislocatio