We describe the treatment of traumatic anterior shoulder instability complicated with Hill-Sachs lesion, using a combined arthroscopic technique of anterior & posterior capsular fixation and infraspinatus tenodesis by means of suture-anchors, in order to fill the humeral head bone defect (i.e. “remplissage”).

We use 2 posterior portals introducing the arthro-scope through the upper one. A double-armed suture-anchor is inserted through each portal piercing the infranspinatous tendon & posterior capsule in an extra-articular mattress mode. The humeral head bone defect is filled with the aforementioned tissues.

18 patients with well established anterior instability were subject to this technique between March 2005 and December 2008. The follow-up time was 6 to 36 months (average 18 months). All were evaluated using the Rowe protocol for shoulder instability which assess stability, ROM & shoulder functionality.

In 13 patients the outcome was assessed as excellent, in 4 good & in 1 average. In one patient, post-op stiffness was developed which managed successfully with conservative means.

The arthroscopic technique of “remplissage” is an innovative choice in the armamentarium of treatment of anterior traumatic instability with concomitant Hill-Sachs lesion. The results of this technique are excellent regarding the recurrence rate of anterior instabiliy (in our series there was none episode of recurrent instability during the study period).

Introduction: It is very common in spine surgery to transfuse substantial amounts of homologous blood. The danger of spreading infectious diseases (HIV, HBV etc.) as well as possible side- effects of multiple transfusions (haemolysis, anaphylaxia, etc.) has created the necessity of finding methods to minimize the amount of homologous blood transfusions. One of these methods is the use of systems for autotransfusion of the patient’s drained blood.

Purpose: Evaluation of the advantages of the use of postoperative autotransfusion systems is spine surgery.

Methods: 26 patients were evaluated, from November 2002 until May 2003, who underwent posterior spinal fusion and to whom postoperative autotransfusion was used. The patients’ group consisted of 19 women and 7 men aged from 14–75 years old (aver.23.8 years of age). We recorded the preoperative haematocrit value, the amount of homologous blood transfused intra- and postoperatively, the amount of autologous blood transfused as well as the haematocrit values at the 1st, 2nd, and 5th postoperative day. Moreover all the patients were observed postoperatively for possible complications relevant to autotransfusion.

Results: 70% of the patients did not require postoperative transfusion with homologous blood. We observed allergic reactions in 4 patients and fever in 3 patients. These findings were not directly correlated to autotrans-fusion, however the autotransfusion was interrupted. There were no major complications. The above mentioned results are considered to be encouraging for further us and study of postoperative autotransfusion systems in spine surgery.