As a common injury, anterior dislocation of the shoulder is estimated to have a lifetime incidence of 2% in the general population. The shoulder is a complex joint that sacrifices stability for the range of motion, and the anterior glenoid lip, the primary stabilizer of the glenohumeral joint, is most likely to be dislocated after injury. More than 95% of shoulder dislocation occurs in the anterior direction. The frequency of posterior and inferior dislocation is low, and the leading cause is trauma. Among anterior traumatic instability of shoulder joint, Bankart injury is the most common pathological change. Translation of the humeral head can lead to avulsion of the glenoid labrum of the scapula, which accounts for 4%-70% of anterior dislocation of the shoulder joint. In addition, there is evidence that each dislocation leads to a decrease in the width of the glenoid and an increase in the defect of the glenoid.

To evaluate clinical healing, functional recovery, and radiological outcomes in patients undergoing arthroscopic modified autologous iliac bone graft surgery for shoulder dislocation with glenoid bone injury.

A single-center case retrospective study with prospectively collected data. Inclusion criteria: traumatic or recurrent anterior shoulder instability with the significant glenoid bone defect; patients with nontraumatic or multidirectional instability were excluded. The modified Eden-Hybinette operation was adopted under arthroscopic and autologous iliac bone transplantation, double-loop titanium plate and triangular elastic fixation with absorbable anchor were used for fixation. All patients were evaluated for recurrence and fear level postoperatively. The American shoulder and elbow surgeons (ASES) , the Oxford shoulder instability score (OSIS) , and Rowe score for instability (ROWE) at 3, 6, 12, and 24 months after surgery were recorded, respectively. The graft healing, complications, and range of motion of the shoulder joint were analyzed. Values were compared using the paired t-test for differences in the normal distribution, otherwise the nonparametric Wilcoxon rank-sum test.

The final cohort included 14 patients with an average age of 30 years, and an average follow-up time of 13 months. 2 patients lost follow-up. At the last follow-up, 12 patients had no recurrence, and the ASES, OSIS, and ROWE scores were (84.0±8.5) point, (18.6 ±3.6) point, and (90.4±5.4) point, respectively. Compared with preoperative evalutions, the scores of all final postoperative functional scores increased significantly, showing excellent results.

Arthroscopic autologous iliac bone block transplantation with double-loop titanium plate and triangular elastic fixation with absorbable anchors can bring good clinical and radiological results for patients with anterior shoulder instability. This modified technique can be used for glenoid defects repair and normal shoulder anatomy restroration.