Objective: The aim is to present a modified arthroscopic remplissage for shoulder Hill-Sachs lesions with high-strength sutures instead of suture anchors, to achieve better tendon-bone healing and avoid failure of remplissage due to anchor detachment.
Material and methods: A total of seven patients with recurrent anterior shoulder dislocation combined with a Hill-Sachs lesion were included in this study. Firstly, anteroinferior glenoid labrum complex damage was treated then 2-3 bone tunnels were punched with a sighting device from the bony defect of the humeral head to the inside of lesser tubercles of the humerus. The bony defect was filled by stitching the infraspinatus tendon through the bony tunnels with high-strength sutures. After the operation, the filling and healing of the infraspinatus tendon in the Hill-Sachs lesion were assessed using magnetic resonance imaging (MRI).
Results: Patients were followed up for 12 months. The results of MRI showed that all of the filled tendons healed well. Postoperative external rotation of the shoulder joint increased on average from 67° to 87°. Compared with the preoperative level, the Oxford Shoulder Instability Score (OSIS) was 18.50 ± 1.04 points higher and the Rowe score was increased by 66.755 ± 0.914 points.
Conclusion: Arthroscopic remplissage of a shoulder Hill-Sachs lesion with high-strength sutures carries the benefits of secure fixing and good tendon-bone healing without the risk of anchor detachment.
Keywords: Arthroscopic remplissage; Bony defect of humeral head; High-strength sutures; Hill-Sachs lesion; Suture anchor.