Arthroscopic Anatomic Glenoid Reconstruction (Distal Tibia Allograft)

Overview

When repeated dislocations have worn away bone from the front of the shoulder socket, the socket can be rebuilt with a bone graft. In arthroscopic anatomic glenoid reconstruction, a piece of donor bone from the lower end of the tibia (a distal tibia allograft, or DTA) is shaped and fixed to the front of the glenoid with screws, working through small incisions with a camera ^[1].

The distal tibia has a cartilage-covered surface whose curve closely matches the shoulder socket, so the graft restores both the bone and a smooth joint surface ^[2]. Because the graft comes from a tissue bank, no bone is taken from your own shoulder.

DTA is used for significant glenoid bone loss, as an alternative to the Latarjet procedure, and for revision after a failed Latarjet or other stabilization surgery ^{[3, 4]}.

Benefits

• Restores bone and a cartilage joint surface
• No graft taken from your own body
• An option after failed Latarjet or prior stabilization surgery

Who is a Candidate?

Arthroscopic Anatomic Glenoid Reconstruction (DTA) may be appropriate for patients who meet certain criteria. Ideal candidates include:

• Recurrent instability with significant glenoid bone loss
• Failed Latarjet or other bone-block procedure
• Patients for whom a Latarjet is not suitable

Recovery & Rehabilitation

Recovery is similar to the Latarjet: a sling for several weeks, staged physical therapy, and return to sports usually four to six months or more after surgery, once the graft has healed.

References

1. Provencher MT, Ghodadra N, LeClere L, et al. Anatomic osteochondral glenoid reconstruction for recurrent glenohumeral instability with glenoid deficiency using a distal tibia allograft. Arthroscopy. 2009;25(4):446-52. doi.org/10.1016/j.arthro.2008.10.017
2. Lorentz SG, Hurley ET, Meyer AM, et al. Distal Tibial Allograft for the Treatment of Shoulder Instability Provides Excellent Results With Low Rates of Recurrent Instability: A Systematic Review of Clinical and Biomechanical Studies. Arthroscopy. 2025;41(11):4804-4814.e2. doi.org/10.1016/j.arthro.2025.05.007
3. Singh M, Byrne R, Chang K, et al. Distal Tibial Allograft for the Treatment of Anterior Shoulder Instability With Glenoid Bone Loss: A Systematic Review and Meta-analysis. Am J Sports Med. 2025;53(1):210-216. doi.org/10.1177/03635465231223124
4. Gilat R, Wong SE, Lavoie-Gagne O, et al. Outcomes are comparable using free bone block autografts versus allografts for the management of anterior shoulder instability with glenoid bone loss: a systematic review and meta-analysis of "The Non-Latarjet". Knee Surg Sports Traumatol Arthrosc. 2021;29(7):2159-2174. doi.org/10.1007/s00167-020-06194-z