The Hill-Sachs "remplissage": An arthroscopic technique for treatment of engaging Hill-Sachs lesion [Die Hill-Sachs-"remplissage": Eine arthroskopische technik zur behandlung der engaging-Hill-Sachs-läsion]

Glenohumeral bone stock insufficiency has been identified as an important negative factor for arthroscopic treatment of traumatic anterior shoulder instability. The Hill-Sachs "remplissage" is an all-arthroscopic technique to treat traumatic anterior shoulder instability with glenoid bone loss and an engaging Hill-Sachs lesion. The principle of the procedure is a capsulotenodesis of the infraspinatus muscle and the posterior joint capsule to fill ("remplissage", french, to fill) the Hill-Sachs lesion. In lateral decubitus position, or alternatively in beach chair position, a posterior portal positioned directly over the Hill-Sachs lesion is established first. An anteroinferior and anterosuperior portal is established afterwards. With the arthroscope in the anterosuperior portal, a preparation and mobilization of the Bankart lesion is carried out followed by freshening of the Hill-Sachs lesion and two suture anchors are placed in the Hill-Sachs defect. The infraspinatus and posterior capsule are penetrated and then pulled into the defect with the knots remaining extra-articular. Finally, the Bankart repair can be finished through the two anterior portals. © 2008 Springer Medizin Verlag.