Alexandre Lädermann1,2,3, Paolo Arrigoni4, Johannes Barth5, Pablo Narbona6, Bryan Hanypsiak7, Stephen S Burkhart8, Patrick J Denard9,10. 1. Division of Orthopaedics and Trauma Surgery, La Tour Hospital, Rue J.-D. Maillard 3, 1217, Meyrin, Switzerland. Alexandre.laedermann@gmail.com. 2. Faculty of Medicine, University of Geneva, Rue Michel-Servet 1, 1211, Geneva 4, Switzerland. Alexandre.laedermann@gmail.com. 3. Division of Orthopaedics and Trauma Surgery, Department of Surgery, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva 21, Switzerland. Alexandre.laedermann@gmail.com. 4. Policlinico San Donato, Università degli studi di Milano, piazza Malan 1, San Donato Milanese, Italy. 5. Clinique des Cèdres, Avenue Albert Londres, Echirolles, France. 6. Department of Shoulder Surgery, Sanatorio Allende, Córdoba, Argentina. 7. Arthrex Inc., Naples, FL, USA. 8. The San Antonio Orthopaedic Group, Department of Orthopaedic Surgery, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA. 9. Southern Oregon Orthopedics, Medford, OR, USA. 10. Department of Orthopaedics and Rehabilitation, Oregon Health and Science University, Portland, OR, USA.
Abstract
PURPOSE: Arthroscopic remplissage of a Hill-Sachs lesion is classically described as a capsulotenodesis of the infraspinatus within the posterolateral humeral head. The aim of this cadaveric study was to evaluate the anatomic relationship between the position of anchors and sutures placed for remplissage and the infraspinatus and teres minor. The hypothesis was that remplissage actually corresponds to a capsulomyodesis of the infraspinatus and teres minor muscles. METHODS: A two-anchor arthroscopic remplissage was performed followed by open dissection of ten fresh-frozen human cadaveric shoulders. The exit point of sutures related to muscle-tendon unit as well as the distance between the anchors and the rotator cuff was measured. RESULTS: The superior sutures were localized generally in the infraspinatus, near the musculotendinous junction. The inferior sutures passed through the teres minor muscle in seven of ten cases. The distance between the superior and inferior anchors and the posterolateral greater tuberosity was 14 ± 2 and 12 ± 3 mm, respectively. CONCLUSIONS: Arthroscopic remplissage is a capsulomyodesis of infraspinatus and teres minor rather than a capsulotenodesis of the infraspinatus alone as previously believed. Muscular damage may explain posterosuperior pain observed in patients who underwent remplissage.
PURPOSE: Arthroscopic remplissage of a Hill-Sachs lesion is classically described as a capsulotenodesis of the infraspinatus within the posterolateral humeral head. The aim of this cadaveric study was to evaluate the anatomic relationship between the position of anchors and sutures placed for remplissage and the infraspinatus and teres minor. The hypothesis was that remplissage actually corresponds to a capsulomyodesis of the infraspinatus and teres minor muscles. METHODS: A two-anchor arthroscopic remplissage was performed followed by open dissection of ten fresh-frozen human cadaveric shoulders. The exit point of sutures related to muscle-tendon unit as well as the distance between the anchors and the rotator cuff was measured. RESULTS: The superior sutures were localized generally in the infraspinatus, near the musculotendinous junction. The inferior sutures passed through the teres minor muscle in seven of ten cases. The distance between the superior and inferior anchors and the posterolateral greater tuberosity was 14 ± 2 and 12 ± 3 mm, respectively. CONCLUSIONS: Arthroscopic remplissage is a capsulomyodesis of infraspinatus and teres minor rather than a capsulotenodesis of the infraspinatus alone as previously believed. Muscular damage may explain posterosuperior pain observed in patients who underwent remplissage.
Authors: James F Griffith; Gregory E Antonio; Patrick S H Yung; Eric M C Wong; Alfred B Yu; Anil T Ahuja; Kai Ming Chan Journal: AJR Am J Roentgenol Date: 2008-05 Impact factor: 3.959
Authors: Thomas J Kremen; Carl-Henri Monfiston; John M Garlich; Milton T M Little; Melodie F Metzger Journal: Arthrosc Sports Med Rehabil Date: 2021-03-15
Authors: Patrick Goetti; Patrick J Denard; Philippe Collin; Mohamed Ibrahim; Pierre Hoffmeyer; Alexandre Lädermann Journal: EFORT Open Rev Date: 2020-09-10