Posterior Labral Repair and Reverse Remplissage for Acute Posterior Instability in High-Risk Athletes

Authors:

Ayham Jaber, M.D, Tyler J. Uppstrom, M.D., Michael Nocek, B.A., Christopher J. Hawryluk, M.B.S., Yazan Jaber, M.D., Colin P. Murphy, M.D., Peter J. Millett, M.D., M.Sc

Abstract:

Posterior shoulder instability is increasingly recognized, particularly among contact athletes subjected to repetitive posterior loading. Posterior dislocation causes an anterior impaction of the humeral head known is a reverse Hill-Sachs lesion. In elite contact sport athletes, a labral repair may not be sufficient. We describe a posterior labral repair with all-suture anchors in the beach-chair position with an adjunct arthroscopic reverse remplissage procedure for added stability. This presents a reliable, minimally invasive treatment option in these high-risk patients.

You can read the full study here: Posterior Labral Repair and Reverse Remplissage for Acute Posterior Instability in High-Risk Athletes

Video Credit:

Ayham Jaber, M.D, Tyler J. Uppstrom, M.D., Michael Nocek, B.A., Christopher J. Hawryluk, M.B.S., Yazan Jaber, M.D., Colin P. Murphy, M.D., Peter J. Millett, M.D., M.Sc

As posted in:

Arthroscopy Techniques

Full name of study:

Posterior Labral Repair and Reverse Remplissage for Acute Posterior Instability in High-Risk Athletes

Summary:

This technique video presents the surgeon's preferred arthroscopic posterior labral repair and reverse remplissage ("reverse ramp lesion") technique for treating posterior shoulder instability. The case involves a 25-year-old professional hockey player with a recent posterior shoulder dislocation, posterior labral tear, and small reverse Hill-Sachs lesion. Using standard anterior and posterior portals, the posterior labrum is debrided, mobilized, and repaired to the glenoid rim using 1.8 mm knotless FiberTak anchors. The reverse Hill-Sachs defect is then treated by securing the subscapularis tendon into the defect with 1.3 mm suture tape and a 4.75 mm SwiveLock anchor, effectively restoring joint congruity. A posterior capsular plication is performed to enhance stability. The procedure achieves excellent reduction and posterior stability, and a structured postoperative rehabilitation program is initiated immediately.

Peter Millett, MD

Average rating:

39 reviews

Alexandra Thompson

Mar 23, 2024

by Alexandra Thompson on Peter Millett, MD

110%

Dr. Millett and his team did a SLAP tear repair and bicep tenodesis on my left shoulder. I use my arms as an artist, and love to swim in the ocean, surf, paddle, and telemark ski. So regaining full use of my shoulder and keeping my bicep attached was very important to me. Now, over two years later, my shoulder has the equivalent range of motion as my other arm and as before the injury, and no pain. After the first three months it felt so good and was so strong that - to my horror - I completely forgot my six-month follow-up.

Not only did Dr. Millett and his team make my arm as good as new, but having had the experience of such kindness and expertise throughout the process of surgery and recovery is like an added shoulder superpower.

Thank you Rita, Brooke, Jason, Sarah, Camille, Olivia, Dr. Millett and everyone! And see you soon when my husband comes in for his knee...

Jeff Chandler

Jan 31, 2022

by Jeff Chandler on Peter Millett, MD

Flawless procedure, Easy recovery

Dr. Millet's repaired my knee and tibia, following a botched operation by a different surgeon. That procedure was virtually pain free and I was weight bearing within a few days. That was 18 years ago and the knee is still strong. A few years after the knee incident, Dr Millet repaired my shoulder. My insurance company approved me for 3 months of disability following that surgery. I was off pain medication in 2 days and had 90% range of motion within a week. I withdrew my disability claim and returned to work within two weeks of surgery. I’m not a famous athlete—just a regular guy. Nonetheless, I was treated like an NFL at the Steadman clinic. Most notable was the time for recovery. Other surgeons perform their hour-long task in the OR and don’t involve themselves in the other functions. Peter and his team manages the entire process from diagnosis, anesthesia, nursing care, and therapy. He takes a holistic approach to patient care and doesn’t skip any steps.

Jenn West

Jul 2, 2021

by Jenn West on Peter Millett, MD

Saved My Life

I went to Dr. Millett after 7 knee surgeries (6 on my right and 1 on my left) and had seen 11 different surgeons who all refused to remove femur metal from my right leg. I am highly allergic to metal and the chronic pain was leaving me bedridden for 3.5wks out of a month. He personally wrote me back on my inquiry, listened to my concerns, scheduled my surgery within a week (due to insurance issues) and personally followed up with my recovery. The level of patient care from Dr. Millett and his ENTIRE team is above any care I have ever received in my 20 years of dealing with orthopedic surgeons. There are not enough words to describe the level of care, dedication and professionalism you receive from Dr. Millett and his staff.
My only disappointment is that I did not find him sooner!!!

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Posterior Labral Repair and Reverse Remplissage for Acute Posterior Instability in High-Risk Athletes

Authors:

Abstract:

Video Credit:

As posted in:

Full name of study:

Summary:

About the Author: Peter Millett, MD