Arthroscopic Anatomical Bone Grafting Using a Novel Bone Tunnel Positioning Guide for Recurrent Anterior Shoulder Dislocation: A Retrospective Study

Introduction: Recurrent anterior shoulder dislocation with anterior glenoid bone loss is a major risk factor for persistent instability, and arthroscopic bone block procedures remain technically demanding, particularly regarding accurate tunnel creation and graft positioning. This study evaluated the short-term outcomes of a novel bone tunnel positioning guide used in arthroscopic bone grafting. Methods In this single-center retrospective series, eight patients (six men, two women; age 22–59 years) with recurrent anterior dislocation and anterior glenoid bone loss > 20%, or width loss > 15% with off-track lesions, underwent arthroscopic Eden–Hybinette reconstruction using autologous iliac crest grafts fixed with two Endobutton. The guide enabled two parallel tunnels perpendicular to the glenoid neck and matching intra-graft tunnels to achieve a flush graft position. Clinical outcomes were assessed with the Constant–Murley, American Shoulder and Elbow Surgeons (ASES), and Rowe scores. Anterior glenoid defect rate (AGDR) was quantified on three-dimensional computed tomography using a best-fitting circle. Pre- and postoperative values were compared using Wilcoxon signed-rank tests. Results All procedures were completed arthroscopically without intraoperative complications, and all wounds healed uneventfully; no infections or neurologic deficits occurred. Postoperation, the Constant–Murley score improved from 40.0 ± 17.3 to 73.4 ± 21.7, the ASES score from 7.2 ± 1.5 to 11.8 ± 2.4, and the Rowe score from 31.9 ± 35.3 to 73.8 ± 25.9 (p < 0.05). The AGDR decreased from 38.8 ± 16.3% to 17.7 ± 12.0% (p < 0.05), indicating restoration of anterior glenoid bone stock. Postoperative imaging demonstrated central, flush graft positioning. Conclusion Arthroscopic bone grafting assisted by a novel bone tunnel positioning guide achieved reliable restoration of glenoid morphology and clinically meaningful functional improvement in patients with anterior instability and significant glenoid bone loss. Level of evidence: IV, non-randomized single-center retrospective study.