Shoulder & elbow · Instability surgery

Remplissage procedure

The arthroscopic remplissage procedure treats shoulder instability with Hill–Sachs lesions by filling the humeral bone defect with the posterior capsule and infraspinatus tendon, secured with Q-FIX™ knotless anchors — often combined with Bankart repair. Consultations with our fellowship-trained sports medicine surgeons in 1–3 days, with surgery typically 2–4 weeks later. Sling use is typically 4–6 weeks, with progressive rehab through 3–4 months and return to sport typically at 5–6 months.

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Often combined with Bankart repair
Q-FIX™ knotless anchors
Surgery in 2–4 weeks
No referral required

Physiotherapist guiding a patient through a lunge exercise

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Often with Bankart repair

The procedure

What is the remplissage procedure?

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.

When is remplissage recommended?

Recurrent shoulder dislocations
Significant Hill–Sachs lesion on imaging
Engaging Hill–Sachs on examination
Often combined with Bankart repair

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.

Surgical technique

Knotless anchor fixation.

Arthroscopic technique using Q-FIX and FiberTak knotless anchors.

1

Arthroscopic visualization

Small incisions allow camera access to assess the Hill–Sachs defect and any labral damage
2

Anchor placement

Two knotless suture anchors are placed into the Hill–Sachs defect on the posterior humeral head
3

Tendon & capsule capture

Sutures are passed through the infraspinatus tendon and posterior capsule
4

Defect filling

The tendon and capsule are pulled into the defect and secured without knots — filling the lesion
5

Stability confirmation

Shoulder stability and range of motion are verified before completing the procedure

Knotless anchor technology

Knotless technology removes the need for bulky knots that can cause irritation, and simplifies the surgical technique for consistent results.

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

Your surgeons

Our remplissage specialists.

Fellowship-trained shoulder & upper-extremity surgeons.

Dr. Jihad Abouali

Knee & shoulder sports medicine

Dr. Bashar Alolabi

Shoulder & upper extremity

Read full surgeon profiles

Your recovery

Recovery after remplissage.

4–6 weeks
1

4–6 weeks

Sling immobilization

Protecting the repair while healing begins
6–12 weeks
2

6–12 weeks

Passive motion

Physical therapy to restore range of motion
3–4 months
3

3–4 months

Strengthening

Progressive exercises to rebuild shoulder strength
5–6 months
4

5–6 months

Return to sport

With surgeon clearance and sport-specific rehab

4–6 weeks

Sling

Protecting the repair while healing begins

3–4 months

Strengthening

Rebuild shoulder strength

5–6 months

Return to sport

With surgeon clearance

Because remplissage tethers the posterior capsule, external rotation may be slightly limited after surgery. Your surgeon will discuss this trade-off during your consultation.

FAQ

Frequently asked questions.

A 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.