Graft Source and Fixation Strategy in Free Bone Block Glenoid Reconstruction for Anterior Shoulder Instability: A Systematic Review Protocol

This protocol describes a systematic review evaluating graft source and fixation strategy in free bone block glenoid reconstruction for recurrent anterior shoulder instability with glenoid bone loss. Eligible graft sources include distal tibial allograft, iliac crest graft, and distal clavicle autograft. Fixation methods include screw, button, and cerclage constructs. Outcomes include recurrent instability, clinical and patient-reported outcomes, graft union and resorption, complications, and reoperation. Comparative and non-comparative clinical studies will be synthesized separately, with meta-analysis performed where sufficient clinical and methodological homogeneity exists. The review will be conducted and reported according to PRISMA guidance.