Abstract
Arthroscopic posterior bone block procedure using cortical screws has been reported since 2012 for management of recurrent posterior instability associated with bone defects. To avoid screw complications, we describe a full arthroscopic technique based on cortical button fixation. With 4 portals (posterior, poster lateral, anterior, and anterolateral), we use a specific glenoid guiding system (to perform 2 tunnels) and 2 cortical buttons fixation. With a specific glenoid guide, the iliac crest bone graft (ICBG) is secured to the posterior glenoid rim by fixation with 2 cortical buttons. The ICBG is positioned protruding outside the joint through the space, and the posterior capsule is repaired while maintaining an extra-articular bone graft. The protruding bone graft increases the concavity of the glenoid with a progressive bony remodeling to improve the posterior stability of the shoulder in our clinical experience.