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The indications for bone block augmentation of the glenoid following recurrent anterior shoulder instability are expanding. Arthroscopic anatomic glenoid reconstruction (AAGR) is an evolving technique with similar clinical results to the Latarjet procedure and other open bone block procedures. Multiple types of bone grafts and fixation techniques have been described, with varying results on bony integration, resorption, articular congruity, and recurrence rates. This review focuses on biomechanics, patient workup, indications, current evidence, and the authors' preferred surgical technique for AAGR., Competing Interests: Disclosure There are no commercial or financial conflicts of interest to disclose. There are no funding sources for any of the authors., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Arthroscopic Bankart repair (ABR) has been accepted as a standard procedure for anterior shoulder instability with a minimum or no glenoid bone loss and an on-track Hill-Sachs lesion if present. However, several controversies exist in the surgical treatment of anterior shoulder instability. This article will discuss some of these controversies in, "simple," dislocations (without bone loss) as well as, "complex," (with critical bone loss). Determining which patients will benefit from an arthroscopic procedure depends on multiple factors including age, activity level, adequate determination of bone loss, performed with feasible and reliable imaging techniques. In the absence of concomitant significant bony and soft tissue pathology, ABR alone can provide satisfactory clinical results on a long-term basis. Controversies, including whether to remove cartilage from the edge of the glenoid, knotted versus knotless anchors, and routine rotator interval closure, still exist. In cases with significant bone loss, several bone restoring procedures have been described, such as, the Latarjet procedure, iliac crest bone graft, arthroscopic anatomic glenoid reconstruction with a frozen distal tibial allograft, and fresh distal tibial allograft reconstruction. This article will address these controversies and provide guidance based on available published data., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Raffy Mirzayan, MD reports a relationship with Arthrex Inc that includes: speaking and lecture fees. Ivan Wong reports a relationship with DePuy Mitek Inc that includes: consulting or advisory and speaking and lecture fees. Ivan Wong reports a relationship with Smith and Nephew Inc that includes: consulting or advisory and speaking and lecture fees. Ivan Wong reports a relationship with CONMED Corp that includes: consulting or advisory and speaking and lecture fees. Ivan Wong reports a relationship with Stryker Orthopaedics that includes: consulting or advisory and speaking and lecture fees. Ivan Wong reports a relationship with Arthrex Inc that includes: consulting or advisory. Ivan Wong reports a relationship with Bioventus LLC that includes: speaking and lecture fees., (Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.)