Arthroscopic Knotless Remplissage for the Treatment of Hill-Sachs Lesions Using the PASTA Bridge Configuration

Recurrent glenohumeral dislocations can produce Hill-Sachs lesions—bony defects on the humeral head resulting from the humerus hitting the glenoid during dislocations. Some of these lesions can engage on the glenoid during motion, producing instability and potentially affecting the success of a labr...

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Main Authors: Alan M. Hirahara, M.D., F.R.C.S.(C)., Wyatt J. Andersen, A.T.C., Kyle Yamashiro, P.T., D.P.T., C.S.C.S.
Format: Article
Language:English
Published: Elsevier 2019-03-01
Series:Arthroscopy Techniques
Online Access:http://www.sciencedirect.com/science/article/pii/S2212628718301907
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author Alan M. Hirahara, M.D., F.R.C.S.(C).
Wyatt J. Andersen, A.T.C.
Kyle Yamashiro, P.T., D.P.T., C.S.C.S.
author_facet Alan M. Hirahara, M.D., F.R.C.S.(C).
Wyatt J. Andersen, A.T.C.
Kyle Yamashiro, P.T., D.P.T., C.S.C.S.
author_sort Alan M. Hirahara, M.D., F.R.C.S.(C).
collection DOAJ
description Recurrent glenohumeral dislocations can produce Hill-Sachs lesions—bony defects on the humeral head resulting from the humerus hitting the glenoid during dislocations. Some of these lesions can engage on the glenoid during motion, producing instability and potentially affecting the success of a labral repair. The remplissage was developed to address these Hill-Sachs lesions and improve stability. French for “filling,” the goal of the remplissage is to fill the Hill-Sachs lesion with the infraspinatus tendon, preventing the margins of the lesion from engaging with the glenoid. Analogous to restoring the rotator cuff footprint during repair, a primary goal of the remplissage is to have the infraspinatus cover the Hill-Sachs lesion. The partial articular supraspinatus tendon avulsion (PASTA) bridge was originally developed for partial-thickness rotator cuff repair in situ, but additional uses have been found in other settings. The PASTA bridge uses a medial row horizontal mattress with a lateral anchor to create a linked construct to effectively distribute force and provide adequate coverage of the lesion. Knotless anchor technology used in this procedure prevents the need for arthroscopic knot tying and potentially damaging knot stacks. This Technical Note describes a remplissage technique using the PASTA bridge configuration to address Hill-Sachs lesions associated with recurrent glenohumeral instability.
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spelling doaj.art-438428e673e6442d8279560995a438002022-12-21T22:48:46ZengElsevierArthroscopy Techniques2212-62872019-03-0183e275e281Arthroscopic Knotless Remplissage for the Treatment of Hill-Sachs Lesions Using the PASTA Bridge ConfigurationAlan M. Hirahara, M.D., F.R.C.S.(C).0Wyatt J. Andersen, A.T.C.1Kyle Yamashiro, P.T., D.P.T., C.S.C.S.2Sacramento, California, U.S.A.; Address correspondence to Alan M. Hirahara, M.D., F.R.C.S.(C)., 2801 K St, #330, Sacramento, CA 95816, U.S.A.Sacramento, California, U.S.A.Results Physical Therapy, Sacramento, California, U.S.A.Recurrent glenohumeral dislocations can produce Hill-Sachs lesions—bony defects on the humeral head resulting from the humerus hitting the glenoid during dislocations. Some of these lesions can engage on the glenoid during motion, producing instability and potentially affecting the success of a labral repair. The remplissage was developed to address these Hill-Sachs lesions and improve stability. French for “filling,” the goal of the remplissage is to fill the Hill-Sachs lesion with the infraspinatus tendon, preventing the margins of the lesion from engaging with the glenoid. Analogous to restoring the rotator cuff footprint during repair, a primary goal of the remplissage is to have the infraspinatus cover the Hill-Sachs lesion. The partial articular supraspinatus tendon avulsion (PASTA) bridge was originally developed for partial-thickness rotator cuff repair in situ, but additional uses have been found in other settings. The PASTA bridge uses a medial row horizontal mattress with a lateral anchor to create a linked construct to effectively distribute force and provide adequate coverage of the lesion. Knotless anchor technology used in this procedure prevents the need for arthroscopic knot tying and potentially damaging knot stacks. This Technical Note describes a remplissage technique using the PASTA bridge configuration to address Hill-Sachs lesions associated with recurrent glenohumeral instability.http://www.sciencedirect.com/science/article/pii/S2212628718301907
spellingShingle Alan M. Hirahara, M.D., F.R.C.S.(C).
Wyatt J. Andersen, A.T.C.
Kyle Yamashiro, P.T., D.P.T., C.S.C.S.
Arthroscopic Knotless Remplissage for the Treatment of Hill-Sachs Lesions Using the PASTA Bridge Configuration
Arthroscopy Techniques
title Arthroscopic Knotless Remplissage for the Treatment of Hill-Sachs Lesions Using the PASTA Bridge Configuration
title_full Arthroscopic Knotless Remplissage for the Treatment of Hill-Sachs Lesions Using the PASTA Bridge Configuration
title_fullStr Arthroscopic Knotless Remplissage for the Treatment of Hill-Sachs Lesions Using the PASTA Bridge Configuration
title_full_unstemmed Arthroscopic Knotless Remplissage for the Treatment of Hill-Sachs Lesions Using the PASTA Bridge Configuration
title_short Arthroscopic Knotless Remplissage for the Treatment of Hill-Sachs Lesions Using the PASTA Bridge Configuration
title_sort arthroscopic knotless remplissage for the treatment of hill sachs lesions using the pasta bridge configuration
url http://www.sciencedirect.com/science/article/pii/S2212628718301907
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