Dr. Wolf didn’t have a name for the procedure yet. He went to medical school in Bordeaux and considered a name for his Hill-Sachs stuffing or filling. French for filling a void, glass or tank is remplissage. “I didn’t know it would become a staple, though it turned out to be my career ‘holy grail’.”
In addition to recalling the above, Dr. Pollack added the following:
“I found an open analog for arthroscopic remplissage by Connolly in a 1972 American Academy of Orthopaedic Surgeons Instructional Course Lecture, as a reverse McLaughlin procedure. As Dr. Wolf intuited, there was already clinical justification and precedent that an infraspinatus/posterior capsular tenodesis would have efficacy for stabilizing the shoulder. The concept of rendering the intra-articular Hill-Sachs lesion extra-articular, and thus preventing engagement of the Hill-Sachs lesion, was Dr. Wolf’s direct answer to De Beer and Burkhart’s landmark article about the substantially higher recurrence rates for the subset of shoulders with bony deficits. Remplissage also has the virtue of providing a direct posterior tenodesis effect as you can see so clearly when you tension and tie the stitches under arthroscopic visualization from the anterosuperior viewing portal that Dr. Wolf also pioneered. Dr. Wolf’s thesis and elegant, straightforward technique still holds water, demonstrates the power of innovation and has become a mainstay in our armamentarium for treating shoulder instability.”
So, that’s the story. And, we hope you enjoy reading some of the classical references, which speak for themselves. In the future, more historical content is planned for our Inside AANA eNewsletter. If you have any feedback, email us at [email protected] and add “REMPLISSAGE” in the subject line. Thanks.
Jonathan B. Ticker, M.D.
Chair, Communications & Technology Committee
Michael E. Pollack, M.D.
Member, Communications & Technology Committee
References Direct links to historical references included.
1. Bankart, A.S.B. (1923). “Recurrent or Habitual Dislocation of the Shoulder Joint.” The British Medical Journal, 2:1123-33.
2. Burkhart, S.S., De Beer, J.F. (2000). “Traumatic Glenohumeral Bone Defects and Their Relationship to Failure of Arthroscopic Bankart Repairs: Significance of the Inverted-Pear Glenoid and the Humeral Engaging Hill-Sachs Lesion.” Arthroscopy, 16:677.
3. Connolly, J.F. (1972). “Humeral Head Defects Associated With Shoulder Dislocation – Their Diagnostic and Surgical Significance.” Instructional Course Lecture, 21:42-54.
4. Hill, H.A., Sachs M.D. (1940). “The Grooved Defect of the Humeral Head: A Frequently Unrecognized Complication of Dislocation of the Shoulder Joint.” Radiology, 35:690-700.
5. McLaughlin, H.L. (1952). “Posterior Dislocation of the Shoulder.” Journal of Bone and Joint Surgery, 34(3):584-90.