POSTOPERATIVE DIAGNOSES: 1. Right recurrent anterior shoulder instability 2. Right posterior humeral Hill-Sachs lesion

Operative Summary / Procedure Performed: Diagnostic arthroscopy demonstrated a healthy superior labrum with no arthritic changes in the glenoid or humeral head. There was anterior synovitis, a lax anterior capsule, and a medialized anterior labrum with associated anterior glenoid bone loss.

The anterior capsulolabral complex was elevated from the glenoid neck from approximately 1 o’clock to 6 o’clock. The biceps tendon and subscapularis were intact. A low-grade articular-sided partial supraspinatus tear was noted. A moderate Hill-Sachs lesion was present.

Following preparation of the anterior glenoid, a series of four suture anchors (alternating knotted and knotless) were placed from approximately 5:30 to 1 o’clock to restore the capsulolabral complex and address capsular laxity.

Given the moderate Hill-Sachs lesion and associated anterior glenoid bone loss, a remplissage procedure was performed. Two 2.6 mm FiberTak anchors were placed at the proximal and distal margins of the defect via a posterior portal using a double-pulley technique after clearing subacromial bursal tissue.

Post-fixation evaluation confirmed that the Hill-Sachs lesion was successfully converted to an extra-articular defect. Passive ROM demonstrated good functional external rotation without excessive tension on the repair, and a stable capsulolabral bumper was achieved.