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Remplissage : When Bankart is not enough!
By Philippe Landreau in category TECHNIQUE
Chief of Surgery Head of Sports Surgery Training Center Aspetar, Orthopaedic and Sports Medicine Hospital Doha, Qatar
The shoulder joint is a ball-and-socket joint. Only 25 to 30 % of the humeral head makes contact with the glenoid surface at any position. This explains that the shoulder has the greatest range of movement of all the joints in the body. In contrary the risk of instability is higher than any other congruent joint. The stability of the gleno-humeral joint relies on the joint surfaces and the muscles (concavity-compression effect), on the capsulo-labral structures and at a lower degree, on the negative intra-articular pressure . Any deficiency of these factors, especially the capsulo-labral structure and the bone structures can lead to shoulder instability.
Glenohumeral instability is a frequent pathology especially in the young athletic population. The incidence of shoulder instability in the population has been estimated to be as high as 2%  and anterior instability is more frequent than posterior instability. Traumatic dislocations lead to soft tissue injuries (capsular and labral injuries) and osseous injuries (glenoid and humeral head). There are specific patient groups that have a higher risk for recurrent dislocation. The young age , the participation in contact sports  and the constitutional hyperlaxity  have been identified as risk factors....
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