A shoulder that repeatedly dislocates can damage both the soft tissues and the bone around the shoulder joint.

One type of damage is a dent in the ball of the shoulder joint (known as Hill Sachs lesion). When the shoulder moves into certain positions, this dent can catch against the edge of the socket and make the shoulder more likely to dislocate again.

Remplissage is a keyhole procedure used to treat this problem. It fills the dent with nearby shoulder tissue, helping prevent the dent from catching on the edge of the socket.

It is often performed together with Bankart repair when both problems are present.

When is remplissage needed?

Remplissage may be recommended in patients with repeated shoulder dislocation when there is a significant dent in the ball of the shoulder that increases the risk of further dislocation.

It may be particularly useful when:

• The shoulder has dislocated repeatedly

• There is a significant dent in the ball of the shoulder

• The dent can catch on the edge of the socket during shoulder movement

• Bankart repair alone may not provide enough stability

The decision depends on the size and position of the dent, the condition of the shoulder socket and the patient's activity level.

What is remplissage?

Remplissage is a keyhole operation that helps prevent a dent in the ball of the shoulder from causing another dislocation.

During the procedure, nearby shoulder tissue is placed into the dent and secured there with strong stitches.

This effectively fills the dent and prevents it from catching against the edge of the socket when the shoulder moves.

Remplissage is commonly performed together with Bankart repair, which restores the torn tissue around the shoulder socket.

What happens during the operation?

The operation is performed through small cuts around the shoulder using a camera and special instruments.

The surgeon first repairs the torn tissue around the socket when required. The dent in the ball of the shoulder is then addressed by placing nearby shoulder tissue into the dent and securing it with strong stitches.

The aim is to make the shoulder more stable and reduce the chance of the dent causing another dislocation.

What are the benefits?

When appropriately selected, remplissage can:

• Improve shoulder stability

• Reduce the chance of repeated dislocation

• Reduce the risk of the dent catching on the socket

• Improve confidence during shoulder movement

• Help patients return to normal activities and sports

The procedure is particularly useful when the dent in the ball of the shoulder is an important reason why the shoulder remains unstable.

What is recovery like?

Recovery is similar to other shoulder-stabilising procedures.

The arm is usually protected in a sling during the early healing period. Shoulder movement is then increased gradually, followed by strengthening exercises.

Regular physiotherapy is important for regaining movement, strength and shoulder control.

Some patients may experience a temporary reduction in shoulder movement, particularly in rotation, during recovery. This usually improves with appropriate rehabilitation.

What are the risks?

Serious complications are uncommon, but possible problems include:

• Infection

• Bleeding

• Shoulder stiffness

• Continued pain

• Reduced shoulder movement

• Continued or recurrent instability

• The shoulder dislocating again

• The need for further surgery

Following your surgeon's advice and keeping up with physiotherapy can help support recovery and protect the repair while it heals.

Frequently Asked Questions

Is remplissage the same as Bankart repair?

No. They treat different problems. Bankart repair repairs the torn tissue around the shoulder socket, while remplissage fills the dent in the ball of the shoulder to prevent it from catching on the socket. They are often performed together.

Will remplissage affect my shoulder movement?

There can be some restriction of shoulder movement, particularly rotation, after the procedure. In most patients this improves with recovery and physiotherapy. The procedure is recommended when the benefit of improved stability is considered greater than this potential limitation.

Can I return to sports after remplissage?

Many appropriately selected patients can return to sports after successful healing and rehabilitation. The return should be gradual and depends on the type of sport and recovery of shoulder movement, strength and stability.