Arthroscopic treatment for shoulder instability caused by Hill-Sachs lesions, filling the bone defect with tissue using knotless anchor technology.
When the shoulder dislocates, the ball of the humerus can impact against the socket, creating a dent called a Hill-Sachs lesion. If this defect is large enough, it can "engage" with the glenoid rim during arm movement, causing the shoulder to dislocate repeatedly.
Remplissage (French for "to fill") is an arthroscopic procedure that addresses this problem by filling the Hill-Sachs defect with the infraspinatus tendon and posterior capsule. This converts the intra-articular defect into an extra-articular one, preventing it from engaging with the socket.
Remplissage is typically performed alongside a Bankart repair (labral repair) when both a Hill-Sachs lesion and labral tear are present—addressing both sources of instability in a single surgery.
Arthroscopic technique using Q-FIX and FiberTak knotless anchors
Arthroscopic Visualization
Small incisions allow camera access to assess the Hill-Sachs defect and any labral damage
Anchor Placement
Two knotless suture anchors are placed into the Hill-Sachs defect on the posterior humeral head
Tendon & Capsule Capture
Sutures are passed through the infraspinatus tendon and posterior capsule
Defect Filling
The tendon and capsule are pulled into the defect and secured without knots—filling the lesion
Stability Confirmation
Shoulder stability and range of motion are verified before completing the procedure
Q-FIX™ Knotless Anchor
All-suture anchor design providing secure fixation with minimal bone removal
FiberTak™ Knotless Anchor
Low-profile, high-strength PEEK anchor for smooth fixation without knot stacks
Knotless technology removes the need for bulky knots that can cause irritation, and simplifies the surgical technique for consistent results.
What to expect after remplissage surgery
Sling Immobilization
Protecting the repair while healing begins
Passive Motion
Physical therapy to restore range of motion
Strengthening
Progressive exercises to rebuild shoulder strength
Return to Sport
With surgeon clearance and sport-specific rehab
External Rotation Restrictions
Because remplissage tethers the posterior capsule, external rotation may be slightly limited after surgery. Your surgeon will discuss this trade-off during your consultation.
Most patients with a Hill-Sachs lesion also have labral damage from the dislocation. Remplissage is commonly performed together with a Bankart labral repair to address both problems in a single surgery.
Learn about Bankart RepairA Hill-Sachs lesion is a compression fracture (dent) in the back of the humeral head (ball of the shoulder) that occurs when the shoulder dislocates. The glenoid rim impacts the humeral head, creating a defect that can cause ongoing instability.
Remplissage may result in a slight reduction in external rotation (typically 5-10 degrees) because it tethers the posterior capsule. For most patients, this is not noticeable in daily activities. Your surgeon will discuss whether this trade-off is appropriate based on your sport or occupation.
Remplissage is almost always performed in combination with a Bankart repair to address both the labral tear and the Hill-Sachs defect. In some cases, it may be combined with a Latarjet procedure for more significant bone loss.
You'll wear a sling for 4-6 weeks, then begin physical therapy to restore motion. Strengthening typically begins at 3-4 months. Most patients return to sports at 5-6 months with surgeon clearance.
No referral is required. You can book a consultation directly. Having recent shoulder MRI or CT imaging is helpful for evaluation, but we can arrange imaging if needed.
Schedule a consultation to discuss your treatment options.
