title: Outcomes of arthroscopic "remplissage": capsulotenodesis of the engaging large Hill-Sachs lesion.
abstract: BACKGROUND
  A Hill-Sachs lesion of the humeral head after a shoulder dislocation is clinically insignificant in most cases. However, a sizable defect will engage with the anterior rim of the glenoid and cause instability even after anterior glenoid reconstruction. The purpose of this study was to evaluate the outcome of arthroscopic capsulotenodesis of the posterior capsule and infraspinatus tendon ("remplissage") to seal a large engaging Hill-Sachs lesion in an unstable shoulder.
  
  
  METHODS
  This was a prospective follow-up study of patients who underwent arthroscopic surgery for recurrent shoulder instability with a large engaging Hill-Sachs lesion from 2007 to 2009. The clinical results were measured preoperatively and postoperatively with the Simple Shoulder test (SST) and the Rowe score for instability.
  
  
  RESULTS
  Eleven patients met the inclusion criteria of this study. The mean follow-up time was 30 months (range 24 to 35 months). At the last follow-up, significant improvement was observed in both scores with no recurrent dislocations. The mean SST improved from 6.6 to 11 (p < 0.001). The mean Rowe Score improved from 10.6 to 85 points (p < 0.001). On average patients regained more than 80% of shoulder external rotation.
  
  
  CONCLUSIONS
  Arthroscopic remplissage for shoulder instability is an effective soft tissue technique to seal a large engaging Hill-Sachs lesion with respect to recurrence rate, range of motion and shoulder function.
authors.affiliation: Arthroscopy and Sports Injuries Unit, Hasharon Hospital, Rabin Medical Center, 7 Keren Kayemet St Petach-Tikva, 49372, Israel. barak_haviv69@hotmail.com
authors.forename: Barak
authors.initials: B
authors.lastname: Haviv
authors.forename: Lee
authors.initials: L
authors.lastname: Mayo
authors.forename: Daniel
authors.initials: D
authors.lastname: Biggs
mesh_terms: D000328:Adult; D001182:Arthroscopy / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D050815:Fractures, Compression / Q000209:etiology / Q000601:surgery*; D006801:Humans; D058430:Humeral Head / Q000601:surgery*; D007593:Joint Instability / Q000601:surgery*; D008137:Longitudinal Studies; D008297:Male; D017060:Patient Satisfaction; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000502:physiology; D012008:Recurrence; D012189:Retrospective Studies; D012783:Shoulder Dislocation / Q000150:complications; D012784:Shoulder Fractures / Q000209:etiology / Q000601:surgery*; D012785:Shoulder Joint / Q000503:physiopathology / Q000601:surgery; D053441:Suture Anchors; D013710:Tendons / Q000601:surgery*; D016896:Treatment Outcome