Arthroscopic Anterior and Posterior Glenohumeral Capsular Augmentation With Gracilis Allograft

Multidirectional instability in patients with connective tissue disorders such as Ehlers-Danlos syndrome (EDS) is difficult to treat due to poor tissue quality and frequent failure of standard repairs. We describe an arthroscopic technique using gracilis tendon allografts to perform an anterior and posterior capsular augmentation in the revision setting with subscapularis deficiency. Allografts are anchored to the glenoid and humeral head in a sling configuration, restoring capsular restraint and stability. This method builds upon prior posterior-only augmentation by providing circumferential support and utilizing allograft to overcome compromised native tissue.