Arthroscopic Remplissage for Engaging Hill-Sachs Lesions in Patients With Anterior Shoulder Instability

Camp, Christopher L.; Dahm, Diane L.; Krych, Aaron J.

doi:10.1016/j.eats.2015.05.003

Cited by 11 publications

(11 citation statements)

References 8 publications

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“…Los pacientes que presentan lesiones de Hill-Sachs, después de una luxación anterior de la articulación glenohumeral, tienen un mayor riesgo de inestabilidad recurrente y fracaso de la cirugía de estabilización de tejidos blandos. 7 La técnica de reincorporación (Remplissage) permite tratar pacientes con defectos humerales como las lesiones de Hill-Sachs grandes, se asocia con la reparación capsulolabral anterior y consiste en una plicatura del infraespinoso sobre el defecto humeral. 8 En sí, la reparación artroscópica de Bankart combinada con la reincorporación de Hill-Sachs puede restaurar la estabilidad del hombro sin un deterioro significativo de la función de éste, en pacientes con lesiones de Hill-Sachs.…”

Section: Discussionunclassified

Experiencia en el manejo de la inestabilidad anterior de hombro con técnica de remplissage

Medélez¹,

Jacobo-Nájera²,

Téllez-Ávila³

et al. 2021

Ortho-Tips

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La dislocación del hombro puede resultar en una variedad de lesiones en donde se ven involucrados los tejidos blandos y óseos de la articulación glenohumeral. Se ha descrito que la lesión de tejido blando más común es un desprendimiento del labrum del borde glenoideo, conocida como lesión de Bankart. 1 Así como se puede presentar una fractura por compresión posterolateral de la cabeza humeral, Experiencia en el manejo de la inestabilidad anterior de hombro con técnica de remplissage Experience in treatment of anterior shoulder instability with remplissage technique

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Section: Discussionunclassified

Experiencia en el manejo de la inestabilidad anterior de hombro con técnica de remplissage

Medélez¹,

Jacobo-Nájera²,

Téllez-Ávila³

et al. 2021

Ortho-Tips

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“…There are a number of investigators who have advocated use of a single-anchor technique with the potential advantage of less damage to the infraspinatus. 17 However, the issue here is whether remplissage with one anchor provides the optimal surface contact area between the bone and infraspinatus as well as adequate construct strength.…”

Section: Discussionmentioning

confidence: 99%

“…2012 16 RT, single anchor Camp et al. 2015 17 Double-barrel RT Bhatia 2015 18 Arthroscopic transtendinous double-pulley RT Parnes et al. 2015 19 …”

mentioning

confidence: 99%

The Tripod-Pulley Technique for Arthroscopic Remplissage in Engaging Hill-Sachs Lesions

Consigliere

Morrissey

Imam

et al. 2017

Arthroscopy Techniques

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Arthroscopic Bankart repair is now a well-established technique for the treatment of shoulder instability. However, failure rates are considerable when significant bony defects are not addressed. Hill-Sachs lesions, present in the vast majority of those with recurrent anterior instability, when of significant dimension and location, may account for some of these failures. The remplissage procedure involves capsulotenodesis of the posterior capsule and the infraspinatus tendon to fill the Hill-Sachs lesion. “Double-pulley” remplissage is a transtendinous technique that has been described elsewhere and that may simplify the procedure. We present a modification of this technique, the “tripod-pulley” technique, which we feel may potentiate healing of the Hills-Sachs lesions of the capsule and infraspinatus by increasing the surface contact area. At the same time, this technique minimizes the risk of potential damage to the infraspinatus as it uses 2.3-mm “all-suture” anchors.

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“…Even though a growing number of studies recommend remplissage, 10,12,24,25 limited data are available on the technical aspects of this technique. 16,[26][27][28] Despite descriptions of techniques to improve the remplissage procedure, even experienced arthroscopists frequently overmedialize sutures, producing a capsulomyodesis 16,17 rather than an infraspinatus tenodesis. 29 To the authors' knowledge, this is the first study to validate a technique that improves the accuracy of suture passage, reducing overmedialization and potentially reducing the associated clinical complications of restricted range of motion and posterior shoulder pain.…”

Section: Discussionmentioning

confidence: 99%

The “Safe Zone” Technique Improves Suture Placement and Accuracy During Arthroscopic Remplissage

Garcia¹,

Degen²,

Liu³

et al. 2017

Orthopedics

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In response to recent concerns about the accuracy of suture passage during arthroscopic remplissage, this study was conducted to determine whether a previously described "safe zone" technique can improve the accuracy of suture passage. A recommended safe zone technique was used for arthroscopic remplissage on 6 cadaveric specimens. The safe zone was described as a region at least 1 cm lateral and no greater than 3 cm distal to the posterolateral acromion. Results were compared with a control group of 6 specimens for which the safe zone technique was not used. For each group, 24 suture passes were performed. In the safe zone group, 83.3% (20 of 24) of sutures passed through the infraspinatus tendon. This was a significant improvement compared with the control group, in which only 25% (6 of 24) of sutures pierced the infraspinatus tendon (P<.01). In the safe zone group, 4.2% (1 of 24) of attempted suture passes were placed through the muscle or musculotendinous junction compared with 75% (18 of 24) in the control group (P<.01). Prevention of overmedialization improved significantly with the safe zone technique. In the safe zone group, both anchors had significantly more lateral (6 to 10 mm) suture passage compared with the control group (P<.01). The safe zone technique also showed greater precision of suture passes, and overall precision (SD) improved in 75% of passes. The safe zone technique significantly improved the accuracy of suture penetration into the infraspinatus tendon during arthroscopic remplissage. This reproducible method may help to prevent the reported complications of remplissage. [Orthopedics. 2017; 40(4):e598-e603.].

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Arthroscopic Remplissage for Engaging Hill-Sachs Lesions in Patients With Anterior Shoulder Instability

Cited by 11 publications

References 8 publications

Experiencia en el manejo de la inestabilidad anterior de hombro con técnica de remplissage

Experiencia en el manejo de la inestabilidad anterior de hombro con técnica de remplissage

The Tripod-Pulley Technique for Arthroscopic Remplissage in Engaging Hill-Sachs Lesions

The “Safe Zone” Technique Improves Suture Placement and Accuracy During Arthroscopic Remplissage

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