Arthroscopic Coracoid Bone Block for Posterior Glenohumeral Instability: Description of Surgical Technique and a Case Report

Document Type : CASE REPORT


Instituto Vita, São Paulo, SP, Brazil


This case report describes the surgical technique of posterior arthroscopic bone block using the 
coracoid graft to treat recurrent posterior dislocations and describes preliminary results. Performance 
of coracoid transfer as a graft for posterior arthroscopic bone block i n one patient (two shoulders) with 
recurrent posterior glenohumeral instability refractory to clinical treatment for six months, excluding 
volition dislocation. The patient was followed up weekly for the first three weeks when the stitches were 
removed. Postoperative computed tomography was performed before the patient was authorized to 
practice contact and aquatic sports (3–4 months after surgery). Patient returned to previous activities 
without complaints or limitations. There were no neurovascular compli cations. The initial results using 
coracoid as a bone graft for posterior instability were positive, and the technique requires reproduction 
to investigate possible complications. To date, no study has been found in the literature that reports an 
open or arthroscopic coracoid bone block technique. 
 Level of evidence: V


Main Subjects

  1. Alepuz ES, Pérez-Barquero JA, Jorge NJ, García FL, Baixauli VC. Treatment of the Posterior Unstable Shoulder. Open Orthop J. 2017; 11:826-847. doi: 10.2174/1874325001711010826.
  2. Cerciello S, Visonà E, Morris BJ, Corona K. Bone block procedures in posterior shoulder instability. Knee Surg Sports Traumatol Arthrosc. 2016; 24(2):604-11. doi: 10.1007/s00167-015-3607-7.
  3. DiMaria S, Bokshan SL, Nacca C, Owens B. History of surgical stabilization for posterior shoulder instability. JSES Open Access. 2019; 3(4):350-356. doi: 10.1016/j.jses.2019.08.008.
  4. Valencia Mora M, Martínez Menduiña A, Hernández Galera C, Pérez Expósito R, Aramberri Gutiérrez M. Risk of neurological injury in posterior bone block surgery for recurrent glenohumeral instability: a cadaveric study. Arch Orthop Trauma Surg. 2018; 138(12):1719-1724. doi: 10.1007/s00402-018-2986-x.
  5. Qi W, Zhan J, Yan Z, Lin J, Xue X, Pan X. Arthroscopic treatment of posterior instability of the shoulder with an associated reverse Hill-Sachs lesion using an iliac bone-block autograft. Orthop Traumatol Surg Res. 2019; 105(5):819-823. doi: 10.1016/j.otsr.2019.03.017.
  6. Langlais T, Hardy MB, Lavoue V, Barret H, Wilson A, Boileau P. Recurrent posterior shoulder instability starting in childhood and adolescence. Bone Joint J. 2020; 102-B (12):1760-1766. doi: 10.1302/0301-620X.102B12.BJJ-2020-0296.R1.
  7. Boileau P, Hardy MB, McClelland Jr WB, Thélu CE, Schwartz DG. Arthroscopic posterior bone block procedure: a new technique using suture anchor fixation. Arthrosc Tech. 2013;2(4):e473-7. doi: 10.1016/j.eats.2013.07.004.
  8. Arner JW, Elrick BP, Nolte PC, Goldenberg B, Dekker TJ, Millett PJ.Posterior Glenoid Augmentation With Extra-articular Iliac Crest Autograft for Recurrent Posterior Shoulder Instability. Arthrosc Tech. 2020; 9(9):e1227-e1233. doi: 10.1016/j.eats.2020.04.023.
  9. Smith T, Goede F, Struck M, Wellmann M. Arthroscopic posterior shoulder stabilization with an iliac bone graft and capsular repair: a novel technique. Arthrosc Tech. 2012; 1(2):e181-5. doi: 10.1016/j.eats.2012.07.003.
  10. Métais P, Grimberg J, Clavert P, et al. Posterior shoulder instability managed by arthroscopic acromial pediculated bone-block. Technique. Orthop Traumatol Surg Res. 2017; 103(8S):S203-S206. doi: 10.1016/j.otsr.2017.09.001.
  11. Bhatia S, Frank RM, Ghodadra NS, et al. The outcomes and surgical techniques of the latarjet procedure. Arthroscopy. 2014; 30(2):227-35. doi: 10.1016/j.arthro.2013.10.013.
  12. Lafosse L, Lejeune E, Bouchard A, Kakuda C, Gobezie R, Kochhar T. The arthroscopic Latarjet procedure for the treatment of anterior shoulder instability. Arthroscopy. 2007;23(11):1242.e1-5. doi: 10.1016/j.arthro.2007.06.008.
  13. Garret J, Nourissat G, Hardy MB, et al. Painful posterior shoulder instability: Anticipating and preventing failure. A study in 25 patients. Orthop Traumatol Surg Res. 2017; 103:S199-S202. doi:10.1016/j.otsr.2017.08.005.
  14. Mojica ES, Schwartz LB, Hurley ET, Gonzalez-Lomas G, Campbell KA, Jazrawi LM. Posterior glenoid bone block transfer for posterior shoulder instability: a systematic review. J Shoulder Elbow Surg. 2021; 30(12):2904-2909. doi: 10.1016/j.jse.2021.06.013.
  15. Altintas B, Martetschläger F, Fritz EM, et al. Conjoint Tendon Tenotomy for Glenoid Exposure in the Setting of Previous Coracoid Transfer. Arthrosc Tech. 2019; 8(11):e1411-e1415. doi: 10.1016/j.eats.2019.07.021.