Arthroscopic Distal Tibial Allograft Reconstruction for Anterior Shoulder Instability

Arthroscopic distal tibial allograft (DTA) reconstruction has recently gained attention for treatment of anterior shoulder instability. Glenoid grafting using the DTA confers more anatomic glenoid reconstruction and recent studies have shown good clinical outcomes similar to the Latarjet procedure, and with negligible complication rates. Patient profile and glenoid assessment using computed tomography (CT) reconstruction images are most important in selecting eligible patients. The inherent advantages of anatomic arthroscopic glenoid reconstruction (AAGR) are: the safety profile of this technique, the quick learning curve, the preservation of subscapularis anatomy and the absence of donor site morbidity. There are no major adverse events reported with arthroscopic DTA. However, graft availability and cost remain a limitation to this graft option. The current chapter describes the surgical technique for AAGR using a distal tibia allograft.