If you have experienced a dislocated shoulder, there are chances it can happen again. Repeated dislocations can stretch the soft tissues and wear down the bone of the shoulder socket (glenoid cavity), leading to chronic instability.
For patients with significant bone loss or ongoing instability a distal tibia allograft may be the best surgical option. This technique uses a piece of cadaver bone and cartilage from the shin bone (distal tibia) to restore the structure of the shoulder socket. The procedure may be recommended when previous procedures such as the Latarjet procedure (corocoid bone transfer) have failed to improve symptoms or are not suitable due to lack of bone,
How Can the Distal Tibia Allograft Procedure Help Shoulder Instability?
The procedure replaces lost bone and damaged cartilage in the shoulder socket (glenoid), helping to reduce the risk of arthritis and restore a more natural socket shape making the joint more stable and functional.
Procedure for Distal Tibia Allograft
The surgery begins with an incision at the front of the shoulder. Unlike the Latarjet procedure, the coracoid bone is not disturbed. Instead, the graft is harvested from a donor distal tibia, shaped, and fixed to the front of the shoulder socket using screws and sometimes a small plate. This graft is preferred as the distal tibia matches the natural curve of the shoulder socket (glenoid), providing an anatomical fit. This is typically an outpatient surgery, allowing patients to return home the same day.
Risks and Considerations
As with any surgery, risks include:
- Hardware issues (with screws or plates)
- Pain after surgery
- Limited return to sports or activities
- Persistent instability
Complication rates are generally lower than with the Latarjet procedure, however prior shoulder surgeries can increase the risk of complications.
Recovery and Physical Therapy
After surgery, Dr. Lewicky and his team will discuss how well the surgery went and review your postoperative plan including care for the surgical site, activity limitations, physical therapy instructions, and followup. You will wear a shoulder brace to protect the repair. Early movement and mobility exercises are limited to the elbow, wrist, and hand.
- Weeks 1–4: Begin passive movements like pendulum exercises as pain allows.
- At 4 weeks: Start gentle shoulder movements up to 90° elevation and external rotation.
- At 6 weeks: Full active motion may begin if healing looks good on X-rays.
- At 3 months: Strengthening exercises begin.
- At 6 months: Most patients return to full activity.
Your surgeon and physical therapy team will tailor your rehab plan for the best recovery.
Outcomes
Distal tibia allograft surgery has shown excellent results. When the graft is placed correctly and heals well, it integrates with your natural bone, restoring joint stability and reducing the chance of future dislocations. Biomechanical research shows that this type of bone graft can restore near-normal joint function.
FAQs
Will I regain full shoulder motion for sports?
Most patients regain excellent function, though minor loss in motion can occur. This typically doesn't affect performance in most sports, except for overhead throwing athletes (like baseball pitchers), who may notice some limitations.
Why isn't this procedure more commonly offered?
Many surgeons are more familiar with arthroscopic soft tissue repairs. Because bone grafting requires specialized training, not all surgeons offer this option—even when it's appropriate.
