Iliac Bone Graft for Recurrent Posterior Shoulder Instability with Glenoid Bone Defect

  • Received : 2014.05.27
  • Accepted : 2014.07.29
  • Published : 2014.12.30


Recurrent posterior shoulder instability is a debilitating condition that is relatively uncommon, but its diagnosis in young adults is increasing in frequency. Several predisposing factors for this condition have been identified, such as the presence of an abnormal joint surface orientation, an osteochondral fracture of the humeral head or glenoid cavity, and a postero-inferior capsuloligamentary deficit, but their relative importance remains poorly understood. Whilst, conservative treatment is effective in cases of hyperlaxity or in the absence of bone abnormality, failure of conservative treatment means that open or arthroscopic surgery is required. In general, soft-tissue reconstructions are carried out in cases of capsulolabral lesions in which bone anatomy is normal, whereas bone grafts have been required in cases where posterior bony Bankart lesions, glenoid defects, or posterior glenoid dysplasia are present. However, a consensus on the exact management of posterior shoulder instability is yet to be reached, and published studies are few with weak evidence. In our study, we report the reconstruction of the glenoid using iliac bone graft in a patient suffering recurrent posterior shoulder instability with severe glenoid bone defect.


Joint instability;Posterior;Bone graft;Ilium


  1. Fuchs B, Jost B, Gerber C. Posterior-inferior capsular shift for the treatment of recurrent, voluntary posterior subluxation of the shoulder. J Bone Joint Surg Am. 2000;82(1):16-25.
  2. Hawkins RJ, Koppert G, Johnston G. Recurrent posterior instability (subluxation) of the shoulder. J Bone Joint Surg Am. 1984;66(2):169-74.
  3. Burkhead WZ Jr, Rockwood CA Jr. Treatment of instability of the shoulder with an exercise program. J Bone Joint Surg Am. 1992;74(6):890-6.
  4. Beall MS Jr, Diefenbach G, Allen A. Electromyographic biofeedback in the treatment of voluntary posterior instability of the shoulder. Am J Sports Med. 1987;15(2):175-8.
  5. Neer CS 2nd, Foster CR. Inferior capsular shift for involuntary inferior and multidirectional instability of the shoulder. A preliminary report. J Bone Joint Surg Am. 1980;62(6):897-908.
  6. Kouvalchouk JF, Coudert X, Watin Augouard L, Da Silva Rosa R, Paszkowski A. Treatment of posterior instability of the shoulder joint using an acromial stop with a pediculated deltoid flap. Rev Chir Orthop Reparatrice Appar Mot. 1993;79(8):661-5.
  7. Sirveaux F, Leroux J, Roche O, Gosselin O, De Gasperi M, Mole D. Surgical treatment of posterior instability of the shoulder joint using an iliac bone block or an acromial pediculated bone block: outcome in eighteen patients. Rev Chir Orthop Reparatrice Appar Mot. 2004;90(5):411-9.
  8. Barbier O, Ollat D, Marchaland JP, Versier G. Iliac bone-block autograft for posterior shoulder instability. Orthop Traumatol Surg Res. 2009;95(2):100-7.
  9. Samilson RL, Prieto V. Dislocation arthropathy of the shoulder. J Bone Joint Surg Am. 1983;65(4):456-60.