An Evidence-Based Approach to Indication for Remplissage.

Overview

abstract

PURPOSE OF REVIEW: Treatment of anterior shoulder instability (ASI) is complex with many factors contributing to surgical decision making. The remplissage is an adjunct surgical technique that can be added at the time of arthroscopic labral repair or glenoid bone block reconstruction to decrease the recurrence rate of ASI post-operatively. The purpose of this review is to highlight the history, indications, and outcomes of remplissage when used for anterior shoulder instability. RECENT FINDINGS: Prior studies have demonstrated that remplissage, when used in addition to an arthroscopic labral repair, can significantly reduce the rate of recurrent instability in patients with both off-track and near-track Hill Sachs lesions. There remains concern that addition of remplissage will negatively affect post-operative range of motion (ROM). However, recent literature suggests no difference observed in ROM when comparing remplissage plus arthroscopic labral repair to arthroscopic labral repair alone. While the addition of a remplissage has promising rates of return to sport, these results are less favorable when a remplissage is performed in an overhead athlete. The remplissage is a powerful surgical tool to utilize in addition to an arthroscopic labral repair or glenoid bone block reconstruction in patients with anterior instability. An understanding of appropriate indications and its influence on post-operative outcomes can assist the surgeon with providing the best possible outcome for each individual patient.