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Double-Allograft Shoulder Stabilization for Multidirectional Instability Is Associated With Improved Function and
Felix H Savoie1, Matthew W Cole1, Lacee K Collins1
1Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, Louisiana, U.S.A.
Arthroscopy, Sports Medicine, and Rehabilitation
|July 22, 2025
Summary
This study introduces a double-allograft technique for severe shoulder instability and hyperlaxity. The procedure demonstrated significant improvements in patient outcomes, offering a safe and effective solution for ligamentous laxity.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Shoulder Reconstruction
Background:
- Severe, symptomatic multidirectional shoulder instability and hyperlaxity present significant management challenges.
- Failure of conservative treatments like physical therapy necessitates advanced surgical interventions.
Purpose of the Study:
- To describe a novel double-allograft technique for severe shoulder instability.
- To introduce a modified Beighton score for patient selection.
- To report long-term outcomes of this surgical approach.
Main Methods:
- Retrospective review of 43 patients (46 shoulders) with multidirectional instability.
- Utilized a double-allograft technique following failed physical therapy.
- Included patients with a Tulane modified Beighton score ≥ 11 and minimum 2-year follow-up.
Main Results:
- Significant improvements in all patient-reported outcome measures from 6 months post-surgery (P < .001).
- Subgroup analyses showed comparable outcomes across gender, age, and Ehlers-Danlos syndrome status.
- Reported 15.2% complications and 10.9% revision surgeries.
Conclusions:
- The double allograft reconstruction technique is a safe and effective option.
- It successfully restores shoulder stability in patients with severe ligamentous laxity.
- The modified Beighton score aids in identifying suitable candidates.
