Arthroscopic anatomic glenoid reconstruction (AAGR) for recurrent shoulder instability.

Posted on: September 2nd, 2025 by Our Team

Arthroscopic anatomic glenoid reconstruction (AAGR) is an advanced procedure for patients with recurrent shoulder instability caused by loss of bone from the front of the socket (glenoid). Rather than relying on soft-tissue repair alone, the surgeon restores the missing bone to re-create the normal contour of the socket and improve stability. This operation is performed by a highly select group of orthopedic shoulder specialists with specific training in complex arthroscopic reconstruction.

Candidates typically include patients with repeated dislocations or subluxations, measurable glenoid bone loss, high-demand or contact athletes, and individuals whose prior soft-tissue stabilization has failed. In these situations, re-building the socket helps reduce the risk of future instability and better supports return to sport or active work.

AAGR offers two primary benefits. First, it is minimally invasive: the entire operation is performed arthroscopically through small incisions, which can limit disruption to nearby tissues and facilitate precise graft placement. Second, by restoring the native shape and surface of the socket with a cartilage-bearing bone graft, the procedure maximizes shoulder stability during cutting, pivoting, and contact loads.

During surgery, the surgeon prepares the front of the glenoid, contours a graft—often a distal tibial allograft—to match the patient’s anatomy, and fixes it flush with the socket using low-profile implants. When needed, associated soft-tissue procedures (such as Bankart repair) are completed in the same setting to address all contributors to instability.

Recovery focuses on protecting the reconstruction while gradually restoring motion, strength, and control. Most patients begin early guided range-of-motion, progress to strengthening, and then return to sport in staged fashion once healing is confirmed. As with any surgery, risks include stiffness, graft nonunion or resorption, hardware irritation, or persistent symptoms; careful patient selection, meticulous technique, and structured rehabilitation help mitigate these risks.

Dr. Daniel Kaplan provides AAGR and other advanced shoulder stabilization procedures in Brooklyn. Patients with recurrent instability or suspected bone loss can schedule a consultation to review imaging and discuss the most appropriate path to durable shoulder stability.