Posterior shoulder instability in goalkeepers: bone block surgery explained
Metal-free bone block surgery let a professional goalkeeper return to play after posterior glenoid instability. Here is what the 2026 case report reveals.
Posterior shoulder instability accounts for up to 24% of all shoulder dislocations, yet it remains underdiagnosed in football goalkeepers whose diving saves place the glenohumeral joint under repeated posterior stress. A 2026 case report in JSES Reviews, Reports, and Techniques documented the first known use of a fully metal-free, interconnected knotless anchor system for arthroscopic posterior glenoid bone block augmentation combined with subscapularis transfer in a professional goalkeeper, achieving successful return to play within 6 months and zero implant-related imaging artefacts on follow-up MRI.
Why goalkeepers are uniquely exposed to posterior shoulder instability
Goalkeepers perform an estimated 40-70 explosive arm actions per match, including diving saves where ground-reaction forces transmit directly through a partially abducted, internally rotated shoulder. That loading vector drives the humeral head posteriorly against a glenoid rim that, in chronic cases, erodes to the point where soft-tissue repair alone cannot restore stability. Studies in overhead and contact athletes report posterior instability in 10-24% of all shoulder dislocation presentations, with goalkeepers overrepresented relative to outfield players.