The shoulder joint is the most flexible in the human body and has an extensive range of motion, so the human shoulder joint is easy to be injured. The stability of the shoulder joint is mainly maintained through the dynamic and static structures of the shoulder joint, and the maintenance of the two structures keeps the shoulder joint in a fixed position. Dynamic parts include the muscles and tendons around the shoulder joint, including the rotator cuff, allowing the shoulder joint to move in different directions. The static structure consists of the inherent anatomy of the shoulder joint, the surrounding ligaments, and the glenoid lip of the shoulder joint. The glenoid lip of the shoulder is a fibrocartilaginous tissue that surrounds the edge of the glenoid and helps stabilize the humeral head during displacement. Shoulder dislocation is common, primarily anterior dislocation, which often occurs in young people with a lot of exercise. High-energy trauma can cause the failure of the anterior static structure, and most of them are traumatic dislocations. Frequent dislocation will develop into recurrent dislocation, often leading to shoulder glenoid labial tear (Bankart injury) , the most common cause of recurrent shoulder dislocation. With the improvement of living standards and sports demand, the incidence of Bankart injury increases. If treatment is delayed or improper, the recurrence rate is high, so the treatment of Bankart has significant clinical value. Shoulder dislocation combined with glenoid defect and surgical method selection are challenging, and arthroscopic iliac bone grafting has a long learning curve and requires doctors with rich experience, so it is difficult to carry out in all sports medicine disciplines.

To investigate the diagnosis and treatment of shoulder Bankart injury and to study the technique and early clinical results of treating recurrent shoulder dislocation combined with glenoid defect using double loops autogenous bone grafting (Eden-Hybbinette procedure) under arthroscopy.

A literature review summarized the diagnosis and treatment of Bankart injury. Ten patients with anterior shoulder instability combined with severe glenoid defect underwent the Eden-Hybbinette procedure with arthroscopic navigation and double loop fixation between January 2021 and October 2022. All patients were followed up for at least 18 months after surgery. The improvement of shoulder joint function was evaluated by comparing patients' ASES scores and Rowe scores before surgery. A protractor measured the range of motion of the shoulder joint, and the three-dimensional model of the shoulder joint was reconstructed by Mimics software through postoperative CT data. The healing, position, and bone resorption of autogenous iliac bone grafts were evaluated.

All patients were followed up. Before surgery, 6 months after surgery, 12 months after surgery, and 18 months after surgery, ASES scores were 60.6, 82.2, 89.4, and 90.8, respectively. Rowe's scores were 35.5, 85.5, 87, and 90, respectively. From the beginning of 6 months to the last follow-up of 18 months, the ASES score and Rowe score were significantly improved, and the difference was statistically significant with a P<0.05. Postoperative CT showed that the bone mass was firmly fixed, and although there was some bone resorption, the bone mass, and glenoid had healed, the fracture line disappeared, and the overall shape of the bone mass was good. No clinical complications, such as unstable bone mass fixation and joint space narrowing, occurred in all patients, and the overall treatment effect was satisfactory.

The Eden-Hybbinette procedure with double loop fixation under arthroscopic guidance has good early clinical results in treating anterior shoulder instability combined with severe glenoid bone defect.