Peer review has expired on this program. It is the viewer’s responsibility to determine the educational value of this historical content.Peer review has expired on this program. It is the viewer’s responsibility to determine the educational value of this historical content.Large engaging Hill-Sachs lesions are known to contribute to the failure rate of a Bankart repair. Anterior glenoid bone loss in instability can be treated successfully with a Latarjet or Bristow procedure. The problem is how to treat a large Hill-Sachs lesion when there is no glenoid bone loss. Currently there are non-anatomical options. One is the remplissage procedure, which has proven useful for tenodesing the posterior cuff into the Hill-Sachs defect. This procedure has a well-described discomfort rate associated with posterior capsular tightness. Another non-anatomical treatment is the Latarjet procedure, which raises questions about correcting the glenoid for a humeral problem. Dr. Bateman demonstrates the assessment and indications for treatment of Hill-Sachs lesions as well as an arthroscopic technique for inserting HemiCAPs® into Hill-Sachs lesions to improve humeral congruity and reduce the failure of Bankart repairs. He also demonstrates "stacking" of HemiCAPs® for more elongated lesions and explains when to combine this procedure with bony glenoid procedures. To date, Dr. Bateman and his team have used HemiCAPs® with 25 patients for 5 years. The arthroscopic technique has been used for 18 months with 2 traumatic failures, which were converted successfully to Latarjet procedures. So far, there have been no complications from the implants in terms of loosening, pain, or infection. Mid-term results are currently under review with publication expected in 2013.