Arthroscopic treatment of Hill-Sachs lesions in glenohumeral instability. "Remplissage" technique

Hill-Sachs lesion is a defect of the posterosuperior aspect of the humeral head that occurs during an episode of instability. Under abduction and external rotation, this lesion may engage the anterior glenoid border, thus favoring instability. It may be the cause of many failed surgical stabilization procedures. We herein describe the arthroscopic remplissage technique, which consists of filling the lesion through capsulotenodesis of the infraspinatus tendon. This maneuver should be always be performed together with anterior capsulolabral repair. The results obtained by the authors and published in the literature are good, with a loss of mobility similar to the one resulting from the isolated arthroscopic Bankart technique. We recommend performing remplissage together with Bankart repair in patients with glenohumeral instability with significant Hill-Sachs lesions without a glenoid defect or with defects less than 25%.