Management of Recurrent Anterior Shoulder Instability After Failed Latarjet by Eden–Hybinette Procedure: About Three Cases

Introduction: Recurrent anterior shoulder instability after a failed Latarjet procedure represents a challenging surgical problem due to the alteration of native stabilizing structures and potential bone loss. The modified Eden–Hybinette procedure using autologous iliac crest graft remains a preferred revision technique to restore glenoid anatomy and joint stability. 

Methods: We performed a retrospective study of three male patients who underwent a modified Eden–Hybinette procedure as a revision technique for recurrent anterior shoulder instability after failed Latarjet. The average interval to recurrence after the primary Latarjet was 52 months. Preoperative evaluation included clinical and radiologic assessment with CT quantification of glenoid bone loss. All procedures were performed through an open deltopectoral approach. An autologous iliac crest bone graft was used to reconstruct the anterior glenoid rim and was secured with two 3.5 mm cortical screws. Functional outcomes were assessed at a mean follow-up of 15 months using the modified Rowe score. 

Results: the trauma was identified as the precipitating factor in one patient, preoperative imaging showed coracoid graft osteolysis in two patients and pseudarthrosis in one. Postoperatively, no recurrence of instability or major complications occurred. All grafts achieved radiographic union, and the mean modified Rowe score was 79, indicating good shoulder stability and function. 

Conclusion: The modified Eden–Hybinette procedure provides a reliable and effective revision option for recurrent instability after failed Latarjet, particularly in cases with significant bone loss. Despite promising short-term outcomes, long-term follow-up is warranted to evaluate graft durability and potential degenerative changes.