Remplissage for Anterior Shoulder Instability History, Indications, and Outcomes

Higher rates of recurrent glenohumeral instability following Bankart repair can be seen in the setting of bipolar bine loss and in young contact athletes. The glenoid track can account for bipolar bone loss to accurately predict engagement of Hill-Sachs lesions with the glenoid rim. Remplissage is a capsulotenodesis of the infraspinatus tendon that has been developed to address engaging, or "off-track," Hill-Sachs lesions. The addition of remplissage to Bankart repair has shown promising reductions in recurrent instability rates for patients with "off-track" Hill-Sachs lesions, subcritical glenoid bone loss, and contact athletes. Concerns exist for the nonanatomic nature of the procedure; however only mild reductions in external rotation have been shown, whereas strength and patient reported outcome data have been excellent.