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A Hill-Sachs lesion (HSL) is a compression fracture on the posterolateral humeral head that can increase the risk of recurrent shoulder instability after isolated arthroscopic Bankart repair.» Remplissage involves capsulotenodesis of the infraspinatus tendon and posterior capsule into the HSL to prevent its engagement with the glenoid rim through extra-articular conversion and restraint against humeral head anterior translation.» The glenoid track concept can be applied preoperatively and intraoperatively to evaluate risk of recurrence and help direct clinical management options for recurrent shoulder instability.» Recent literature supports expanding indications for remplissage to include patients with on-track HSLs who are at increased risk of recurrence including collision athletes, military personal, and patients with joint hyperlaxity.» New techniques and suture constructs have demonstrated improved biomechanical strength while avoiding the need to access the subacromial space.

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All-suture anchors or so-called “soft” anchors, initially adapted for labral repairs, have increased in popularity for use in rotator cuff repair because of their smaller size, decreased occupation of the footprint, improved points of fixation, ease of use, and ease of revision.In limited series, soft anchors have demonstrated equivalent biomechanical and clinical performance compared with hard body anchors for rotator cuff repair.Perianchor cyst formation can occur with both hard body and soft anchors.Biomechanical and clinical data support aiming for vertical angles of insertion for soft anchors.