Excellent Clinical and Radiological Mid-term Outcomes of the Arthroscopic "Double-Inlay" Eden-Hybinette Procedure for Bone Defects Exceeding 20%: A 5-Year Case Series.

Background: Eden-Hybinette procedure can maximize the restoration of the glenoid defect by harvesting a proper size of iliac bone block. We developed an arthroscopic "double-inlay" Eden-Hybinette procedure to achieve better bone union of the graft. The aim of this study was to evaluate the clinical and radiological mid-term outcomes of the arthroscopic "double-inlay" Eden-Hybinette procedure for bone defects exceeding 20%.

Methods: A retrospective case series was conducted. The inclusion criterion was a bone defect exceeding 20%, especially failed Bristow-Latarjet procedure or recurrent anterior shoulder instability among patients with epilepsy. An arthroscopic "double-inlay" Eden-Hybinette procedure was carried out. Recurrence and apprehension, the ASES, UCLA, SSV, Rowe, and VAS pain scores and rate of return to sports were obtained at final follow-up. Graft position, healing, and resorption were evaluated via 3D computerized tomography scan. Moreover, postoperative complications and the incidence of osteoarthritis (OA) were recorded.

Results: The study cohort included 15 patients, with a mean age of 34.9 ± 13.2 years (range, 19-59 years) and a mean follow-up duration of 5 ± 1.7 years (range, 2.0-8.0 years). No patients experienced recurrent dislocation, and the VAS pain and instability scores during shoulder range of motion decreased from a mean 6.5 ± 2.3 and 9.6 ± 0.9 preoperatively to 1.9 ± 1 and 2 ± 1.7 at the last follow-up (P < .001). The Rowe, ASES, UCLA and SSV scores of the patients increased from 18.7 ± 10.6, 71.8 ± 5, 22.9 ± 3.5 and 49.3 ± 16.2 preoperatively to 90.3 ± 6.2, 90.1 ± 4.2, 30.1 ± 2.4 (P < .001) and 81.1 ± 15.7 (P = .001) postoperatively. At the final follow-up, the bone graft healing rate was 100%, and there was no severe bone resorption. All patients returned to work, and 73.3% of patients (11 of 15) returned to sports at their preinjury or higher level.

Conclusions: The arthroscopic "double-inlay" Eden-Hybinette procedure has demonstrated reliability and efficacy, yielding excellent mid-term clinical and radiological outcomes for bone defects exceeding 20%, particularly in cases of failed Bristow-Latarjet procedures or in patients with epilepsy.