The etiology and patho-mechanics of recurrent gleno-humeral dislocations are not completely known (Alkaduhimi et al., 2016; Arciero et al., 2015; Burkhart & De Beer, 2000; Di Giacomo et al., 2016; Shin et al., 2016; Symeonides, 1989; Symeonides, 1972) and optimal surgical management of anterior shoulder instability remains controversial. Few studies have been carried out on post-traumatic capsular elongation and hyperlaxity or on the healing process of the soft tissue on the glenoid edges after the first dislocation and after capsulolabral repair (Marco et al., 2017; Bonazza et al., 2017). On the contrary, considerable attention has been focused on the correlations among glenoid bone loss, humeral head defects and instability, particularly in the recurrent forms if correlated with engaging Hill-Sachs lesions (Cautiero et al., 2017). Recent studies show the biomechanical aspects of restoring the glenoid width using bone augmentation and the role of the anterior capsule in recentering the humeral head on the glenoid fossa (Arciero et al., 2015; Alvi et al., 2016; Fortun et al., 2016). Furthermore, severe bone lesions of the glenoid rim and the Hill-Sachs defect on the humeral head are associated with poor quality capsular tissues (Arciero et al., 2015; Burkhart & De Beer, 2000; Symeonides, 1972; Cole & Warner, 2000). Different techniques for surgical treatment of traumatic and atraumatic recurrent shoulder instability have been previously described, but arthroscopic Bankart repair is the most popular. The failure rate of this technique is reported to be from 15% to 64%, especially in unselected patients with severe glenoid bone loss (Burkhart & De Beer, 2000; Shin et al., 2016; Degen et al., 2016). The association of glenoid bone loss and capsular inconsistence represents the real limit of a standard arthroscopic anterior capsulorrhaphy or an isolated bone graft procedure (Cole et al., 2000; Field et al., 1999; Kleiner et al., 2016; Lafosse et al., 2007; Provencher et al., 2007). The remplissage technique has been proposed as a support for capsular insufficiency and for engaging Hill Sachs lesions, but the results are controversial, and failures are reported to be from 4% to 15% (Wolf & Arianjam, 2014). The use of a tendon sling made around the subscapularis tendon was proposed to prevent anterior instability in the shoulder, using a hamstring graft and enhancing the anterior rim of the glenoid with the same graft (Klungsøyr et al., 2015). Currently, the open or arthroscopic Latarjet procedures are considered to be the most effective techniques for treatment in cases of severe bone defects and poor-quality anterior soft tissue due to the coracoid transfer and conjoint tendon action, with a recurrency between 0 and 5% (Degen et al., 2016; Lafosse et al., 2007; Wolf & Arianjam, 2014; An et al., 2016; Cassagnaud et al., 2003; Latarjet, 1954; Matton et al., 1992; Russo et al., 1990; Russo et al., 1998; Steffen & Hertel, 2013; Taverna et al., 2006; Torg et al., 1987; Vander Maren et al., 1993). Also the conjoined tendon transfer allows stability restoration with no significant range-of-motion loss and a low recurrence rate (Douoguih et al., 2018).