Posterior Arthroscopic Anatomic Glenoid Reconstruction

Posterior bone loss following posterior instability of the shoulder can lead to poor patient outcomes and increased likelihood of subsequent dislocations. Unlike in cases of anterior instability, the critical amount of bone loss that warrants surgical intervention in posterior instability has not been established. Posterior instability and bone loss are commonly seen in traumatic settings where cumulative dislocations occur. Similar to surgical treatment of anterior instability, both arthroscopic and open procedures have been used, with the former gaining momentum as the preferred method. To address resultant bone loss, surgeons can use a variety of grafting techniques and sources for augmentation of the posterior glenoid deficit. Here we describe an adaptation of the arthroscopic anatomic glenoid reconstruction for posterior instability with bone loss using a distal tibia allograft. This arthroscopic technique allows for excellent surgical visualization, graft delivery, and anatomic reconstruction of the articular surface of the glenoid.