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Updated: Jun 22, 2026
Anterior Capsular Reconstruction with Human Dermal Allograft for Irreparable Subscapularis Tears
Published on: May 9, 2025
Open reconstruction of large bony glenoid erosion with allogeneic bone graft for recurrent anterior shoulder
Pei-Wei Weng1, Hsain-Chung Shen, Hsieh-Hsing Lee
1Department of Orthopedic Surgery, Taipei Medical University Hospital, Taipei, Taiwan.
Background:
Severe glenoid bone loss in recurrent anterior glenohumeral instability is rare and difficult to treat.
Purpose:
The authors present a surgical technique using allogeneic bone grafting for open anatomic glenoid reconstruction in addition to the capsular shift procedure.
Study Design:
Case series; Level of evidence, 4.
Methods:
Nine consecutive patients with a history of recurrent anterior shoulder instability underwent reconstruction of large bony glenoid erosion with a femoral head allograft combined with an anteroinferior capsular shift procedure. Preoperative computed tomographic and arthroscopic evaluation was performed to confirm a > or =120 degrees osseous defect of the anteroinferior quadrant of the glenoid cavity, which had an "inverted-pear" appearance. Patients were followed for at least 4.5 years (range, 4.5-14). Serial postoperative radiographs were evaluated. Functional outcomes were assessed using Rowe scores.
Results:
All grafts showed bony union within 6 months after surgery. The mean Rowe score improved to 84 from a preoperative score of 24. The mean loss of external rotation was 7 degrees compared with the normal shoulder. One subluxation and 1 dislocation occurred after grand mal seizures during follow-up. These 2 patients regained shoulder stability after closed reduction. The remaining patients did not report recurrent instability. All patients resumed daily activities without restricted motion.
Conclusion:
This technique for open reconstruction is viable for the treatment of recurrent anterior glenohumeral instability with large bony glenoid erosion.