E. Mataragas, C. Vassos, N. Tzanakakis, G. Mouzopoulos,
C.K. Yiannakopoulos, Emm. Antonogiannakis
Orthopaedic Dpt. – Shoulder and Arthroscopy Unit,
IASO GENERAL Hospital
OUR EXPERIENCE WITH “REMPLISSAGE”
IN CASES WITH HUMERAL BONE LOSS
Hill Sachs Lesion
Impression fracture of the posterolateral
Present in 90% of anterior dislocations and
25% of anterior subluxations. (Calandra JJ,
Can also be reverse.
Less than 20% of head (minor)
Between 20-45% of head (moderate)
Greater than 45% of head (severe)
Burkhart SS, De Beer JF : Arthroscopy 2003;19 : 732–739
Grade I: defect in the articular surface down to
Grade II: includes the subchondral bone
Grade III: large subchondral defect
Calandra et. Al, 1989
Most Hill-Sachs lesions are small and don’t
Each lesion should be evaluated during surgery.
- Lesions found to be engaging in a normal ROM.
- Lesions representing >30% of the articular surface.
To evaluate the Remplissage arthroscopic technique
as described by Eugene Wolf used in patients with
traumatic shoulder instability that present glenoid
bone loss and Hill Sachs defects.
Retrospective, continuous, monocentric
Series of 28 patients
Epidemiology 23M, 5F
-Mean age of patients: 31
-Revision surgery: 4
-Joint hypermobility: 14
10 Overhead & Contact
No sports: 10
Follow up ranged from 5-28 months
Post op rehabilitation was supervised by a
doctor dedicated to shoulder problems.
Recurrence and functional outcome were
evaluated pre-op and post-op with the Rowe
One Surgeon (A.E.) performed all the procedures.
The arthroscopic procedure performed was the
Remplissage technique as described by Eugene
Wolf in conjuction with a typical soft tissue
Hill Sachs 28
Large or medium Glenoid loss 11
“Inverted pear” glenoid shape 4
“Bony” Bankart Lesion 6