{"id":26678,"date":"2025-08-05T13:52:00","date_gmt":"2025-08-05T10:52:00","guid":{"rendered":"https:\/\/www.utkuerdemozer.com\/?p=26678"},"modified":"2025-09-08T11:35:58","modified_gmt":"2025-09-08T08:35:58","slug":"arthroscopic-remplissage-surgery-in-shoulder-dislocation","status":"publish","type":"post","link":"https:\/\/www.utkuerdemozer.com\/en\/arthroscopic-remplissage-surgery-in-shoulder-dislocation\/","title":{"rendered":"Arthroscopic Remplissage Surgery in Shoulder Dislocation"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">One of the problems causing recurrent instability after <a href=\"https:\/\/www.utkuerdemozer.com\/en\/dislocated-shoulder-and-surgery\/\">shoulder dislocation<\/a> is the depression lesions that develop on the humeral head. During anterior shoulder dislocation, the humeral head strikes the anterior rim of the glenoid, causing damage both in the socket and in the posterior-lateral part of the head. This depression is called a <a href=\"https:\/\/www.utkuerdemozer.com\/en\/dislocated-shoulder-and-surgery\/\">Hill-Sachs lesion<\/a>. If this lesion is large and increases the risk of recurrent dislocation, only <a href=\"https:\/\/www.utkuerdemozer.com\/en\/dislocated-shoulder-and-surgery\/\">labrum repair (Bankart repair)<\/a> is not sufficient. In such situations, an additional arthroscopic technique called remplissage comes into play, which fills the defect with soft tissue.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Why Is Remplissage Performed?<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">During anterior shoulder dislocations, the humeral head strikes the anterior rim of the glenoid and causes two types of injuries:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>A <a href=\"https:\/\/www.utkuerdemozer.com\/en\/dislocated-shoulder-and-surgery\/\">Bankart lesion<\/a> in the anteroinferior part of the socket<\/li>\n\n\n\n<li>A compression-type defect in the posterior-lateral humeral head<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">This depression is called a Hill-Sachs lesion and can be imagined like the mark left on a ping-pong ball.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">In some cases, this depression may be deep and wide. If this is ignored and only Bankart repair is performed, the shoulder may redislocate. In many failed shoulder stabilization surgeries, the reason is that the Hill-Sachs lesion was not treated. In such cases, the remplissage technique, which aims to fill the depression with soft tissue, is applied.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">What Is Remplissage in Shoulder Dislocation Surgery?<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The word \u201cremplissage\u201d comes from French and means \u201cto fill.\u201d With this technique, the depression (Hill-Sachs lesion) on the humeral head is filled, preventing the shoulder from redislocating.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">When Is Remplissage Surgery Needed?<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The remplissage technique is not used in every shoulder dislocation. However, in some specific cases, it is necessary to prevent the shoulder from redislocating. It is especially preferred in the following situations:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>If there is a large Hill-Sachs lesion (deep depression on the humeral head)<\/li>\n\n\n\n<li>If the depression corresponds to the socket and creates an engagement risk (off-track lesion)<\/li>\n\n\n\n<li>If there is <a href=\"https:\/\/www.utkuerdemozer.com\/en\/dislocated-shoulder-and-surgery\/\">bone loss in the glenoid<\/a> (anterior-posterior balance disrupted)<\/li>\n\n\n\n<li>If arthroscopic Bankart repair alone will be insufficient<\/li>\n\n\n\n<li>In patients with a history of recurrent dislocations and structural problems in the shoulder<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">These criteria are determined by the surgeon using imaging and arthroscopic evaluation. During surgery, if the depression on the humeral head has a high risk of engaging with the socket, the surgeon performs remplissage as an additional procedure.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">What Do \u201cOn-Track\u201d and \u201cOff-Track\u201d Lesions Mean in Shoulder Dislocation?<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Think of the glenoid socket as a tire and the depression on the humeral head as a pothole in the road. If the pothole is small, the tire does not fall into it. But if the pothole is large or the tire is smaller (i.e., there is bone loss), the tire will fall into the pothole and get stuck. In this case, the shoulder may redislocate.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">This is called an off-track lesion in medical terminology. In such a case, repairing only the labrum is not enough. To prevent the tire from falling into the pothole, the pothole must be filled. This \u201cfilling\u201d process is the remplissage technique.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>On-Track Lesion:<\/strong> The Hill-Sachs depression does not meet the glenoid rim. Bankart repair alone may be sufficient.<\/li>\n\n\n\n<li><strong>Off-Track Lesion:<\/strong> The Hill-Sachs lesion engages the glenoid rim during shoulder movement. In this case, remplissage must be added to Bankart repair.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">How Is Remplissage Surgery Performed?<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Remplissage is an <a href=\"https:\/\/www.utkuerdemozer.com\/en\/shoulder-arthroscopy\/\">arthroscopic (minimally invasive) surgery<\/a> and is usually performed in the same session as Bankart repair. No additional incision is required; the existing arthroscopic portals are used.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>After Bankart repair is completed, the Hill-Sachs lesion on the humeral head is evaluated with an arthroscopic camera.<\/li>\n\n\n\n<li>The lesion area is cleaned with special instruments via the posterior portal.<\/li>\n\n\n\n<li>A special anchor with sutures is placed into this area.<\/li>\n\n\n\n<li>The suture threads are passed through the <a href=\"https:\/\/www.utkuerdemozer.com\/en\/rotator-cuff-syndrome\/\">infraspinatus tendon<\/a> and posterior capsule.<\/li>\n\n\n\n<li>The sutures are tied with the \u201cparachute technique.\u201d The depression is filled with soft tissue.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">As a result, the depression on the humeral head is functionally moved outside the joint. The risk of engaging with the glenoid rim is eliminated, and the risk of redislocation is significantly reduced.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Advantages of the Remplissage Technique<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Moves the Hill-Sachs lesion extra-articularly, preventing engagement<\/li>\n\n\n\n<li>Reduces redislocation risk in off-track lesions<\/li>\n\n\n\n<li>Performed arthroscopically; no additional incision is needed<\/li>\n\n\n\n<li>Preserves <a href=\"https:\/\/www.utkuerdemozer.com\/en\/rotator-cuff-syndrome\/\">rotator cuff<\/a> function; although the infraspinatus tendon is used, significant loss of external rotation is rare<\/li>\n\n\n\n<li>Can be combined with Bankart repair in the same surgical session<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Recovery After Remplissage Surgery<\/h2>\n\n\n\n<figure class=\"wp-block-image is-resized\"><img decoding=\"async\" src=\"https:\/\/utkuerdemozer.com\/wp-content\/uploads\/2025\/06\/f7cce4_04d3bf30545d4a7b8aa69ac62131a132mv2-9.jpg\" alt=\"\" style=\"width:326px;height:auto\"\/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">Since remplissage is usually performed together with Bankart repair, the recovery process is the same. Remplissage alone does not prolong recovery.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>First 3\u20134 weeks:<\/strong> The arm is immobilized with a sling. Passive and assisted exercises are performed.<\/li>\n\n\n\n<li><strong>Weeks 4\u20136:<\/strong> Active movements and strengthening exercises are started.<\/li>\n\n\n\n<li><strong>Weeks 8\u201312:<\/strong> Functional exercises and sports preparations are performed.<\/li>\n\n\n\n<li><strong>After 3 months:<\/strong> Return to daily activities is possible. Contact sports usually allowed between 4\u20136 months.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Note: Since the infraspinatus tendon is used during remplissage, some patients may experience mild restriction in external rotation, but this rarely causes functional limitations.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Frequently Asked Questions (FAQ) About Remplissage in Shoulder Dislocation Surgery<\/h2>\n\n\n<div id=\"rank-math-faq\" class=\"rank-math-block\">\n<div class=\"rank-math-list \">\n<div id=\"faq-question-1\" class=\"rank-math-list-item\">\n<h3 class=\"rank-math-question \">What is the role of remplissage in recurrent shoulder dislocation surgery?<\/h3>\n<div class=\"rank-math-answer \">\n\n<p>It fills the Hill-Sachs lesion with soft tissue, preventing redislocation.<\/p>\n\n<\/div>\n<\/div>\n<div id=\"faq-question-2\" class=\"rank-math-list-item\">\n<h3 class=\"rank-math-question \">Is remplissage performed in every shoulder dislocation case?<\/h3>\n<div class=\"rank-math-answer \">\n\n<p>No. It is only performed in patients with large Hill-Sachs lesions and off-track defects.<\/p>\n\n<\/div>\n<\/div>\n<div id=\"faq-question-3\" class=\"rank-math-list-item\">\n<h3 class=\"rank-math-question \">Does remplissage prolong the recovery period?<\/h3>\n<div class=\"rank-math-answer \">\n\n<p>No. Since it is performed in the same session as Bankart repair, it does not add to recovery time.<\/p>\n\n<\/div>\n<\/div>\n<div id=\"faq-question-4\" class=\"rank-math-list-item\">\n<h3 class=\"rank-math-question \">Does remplissage limit external rotation?<\/h3>\n<div class=\"rank-math-answer \">\n\n<p>Mild restriction in external rotation may occur in some patients, but this usually does not affect daily life.<\/p>\n\n<\/div>\n<\/div>\n<div id=\"faq-question-5\" class=\"rank-math-list-item\">\n<h3 class=\"rank-math-question \">Does remplissage prevent sports participation?<\/h3>\n<div class=\"rank-math-answer \">\n\n<p>Non-contact sports are usually safe. However, in elite throwing athletes, external rotation needs careful evaluation.<\/p>\n\n<\/div>\n<\/div>\n<div id=\"faq-question-6\" class=\"rank-math-list-item\">\n<h3 class=\"rank-math-question \">What happens if remplissage is not performed when necessary?<\/h3>\n<div class=\"rank-math-answer \">\n\n<p>If an off-track lesion is left untreated, the risk of redislocation is high.<\/p>\n\n<\/div>\n<\/div>\n<div id=\"faq-question-7\" class=\"rank-math-list-item\">\n<h3 class=\"rank-math-question \">In which cases is remplissage not preferred?<\/h3>\n<div class=\"rank-math-answer \">\n\n<p>In small Hill-Sachs lesions, on-track lesions, or in high-level athletes where external rotation is critical.<\/p>\n\n<\/div>\n<\/div>\n<div id=\"faq-question-8\" class=\"rank-math-list-item\">\n<h3 class=\"rank-math-question \">What are the alternatives if remplissage is not suitable?<\/h3>\n<div class=\"rank-math-answer \">\n\n<p>If there is significant glenoid bone loss, procedures like the Latarjet surgery are preferred.<\/p>\n\n<\/div>\n<\/div>\n<div id=\"faq-question-9\" class=\"rank-math-list-item\">\n<h3 class=\"rank-math-question \">Is remplissage an open surgery?<\/h3>\n<div class=\"rank-math-answer \">\n\n<p>No. It is performed arthroscopically without an additional incision.<\/p>\n\n<\/div>\n<\/div>\n<div id=\"faq-question-10\" class=\"rank-math-list-item\">\n<h3 class=\"rank-math-question \">Can the shoulder redislocate after remplissage?<\/h3>\n<div class=\"rank-math-answer \">\n\n<p>With correct patient selection and proper surgical technique, the risk of redislocation is very low.<\/p>\n\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n\n\n<h2 class=\"wp-block-heading\">Conclusion<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Remplissage is an effective additional procedure for patients with off-track Hill-Sachs lesions. When combined with Bankart repair, it significantly reduces the risk of redislocation. The decision should always be made by an <a href=\"https:\/\/www.utkuerdemozer.com\/en\/about\/\">orthopedic specialist<\/a> after detailed evaluation.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>One of the problems causing recurrent instability after shoulder dislocation is the depression lesions that [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":22998,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[49,47],"tags":[],"class_list":["post-26678","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-sport-surgery-and-arthroscopy","category-shoulder-surgery"],"_links":{"self":[{"href":"https:\/\/www.utkuerdemozer.com\/en\/wp-json\/wp\/v2\/posts\/26678","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.utkuerdemozer.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.utkuerdemozer.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.utkuerdemozer.com\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.utkuerdemozer.com\/en\/wp-json\/wp\/v2\/comments?post=26678"}],"version-history":[{"count":1,"href":"https:\/\/www.utkuerdemozer.com\/en\/wp-json\/wp\/v2\/posts\/26678\/revisions"}],"predecessor-version":[{"id":26679,"href":"https:\/\/www.utkuerdemozer.com\/en\/wp-json\/wp\/v2\/posts\/26678\/revisions\/26679"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.utkuerdemozer.com\/en\/wp-json\/wp\/v2\/media\/22998"}],"wp:attachment":[{"href":"https:\/\/www.utkuerdemozer.com\/en\/wp-json\/wp\/v2\/media?parent=26678"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.utkuerdemozer.com\/en\/wp-json\/wp\/v2\/categories?post=26678"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.utkuerdemozer.com\/en\/wp-json\/wp\/v2\/tags?post=26678"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}