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The procedure aims to convert a bony intra\u2010articular defect into an extra\u2010articular defect by insetting the infraspinatus into the Hill\u2010Sachs lesion. The arthroscopic procedure is performed with the patient in the lateral decubitus position, and the same portals used for anterior instability repair are used for this technique. The sequence of steps involves placing and passing the glenoid anchors and sutures and then waiting to tie the anterior sutures until after the humeral suture anchors have been placed. The subacromial bursa is cleared; then 2 transtendon suture anchors are placed in the Hill\u2010Sachs lesion. Next, the previously placed Bankart repair sutures are tied, and finally, the\n                    <jats:italic>remplissage<\/jats:italic>\n                    sutures are tied in the subacromial space over the infraspinatus by use of the transtendon double\u2010pulley technique. This technique uses the eyelets of the 2 suture anchors as pulleys and creates a double\u2010mattress suture.\n                  <\/jats:p>","DOI":"10.1016\/j.arthro.2009.06.011","type":"journal-article","created":{"date-parts":[[2009,11,5]],"date-time":"2009-11-05T07:43:29Z","timestamp":1257407009000},"page":"1343-1348","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":151,"title":["Arthroscopic Double\u2010Pulley\n                    <i>Remplissage<\/i>\n                    Technique for Engaging Hill\u2010Sachs Lesions in Anterior Shoulder Instability Repairs"],"prefix":"10.1002","volume":"25","author":[{"given":"Samuel S.","family":"Koo","sequence":"first","affiliation":[{"name":"The San Antonio Orthopaedic Group San Antonio Texas U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen S.","family":"Burkhart","sequence":"additional","affiliation":[{"name":"The San Antonio Orthopaedic Group San Antonio Texas U.S.A."},{"name":"Department of Orthopaedic Surgery University of Texas Health Science Center at San Antonio San Antonio Texas U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eloy","family":"Ochoa","sequence":"additional","affiliation":[{"name":"The San Antonio Orthopaedic Group San Antonio Texas U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2009,11,1]]},"reference":[{"key":"e_1_2_2_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/jars.2000.17715"},{"key":"e_1_2_2_3_1","first-page":"113","article-title":"Instability of the shoulder: Complex problems and failed repairs: Part II: Failed repairs","volume":"47","author":"Flatow E.L.","year":"1998","journal-title":"Instr Course 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