In six cases, the tricortical bone graft was harvested from the clavicle because we had only the shoulder specimen. The graft was tailored, cutting off one side of it, so that the one side of the curved cortical aspect was flattened to make it cancellous and compatible with the glenoid bone defect. The graft dimensions were 20 mm × 9 mm × 9 mm. Two 2.8 mm drill holes were made 10 mm apart and 5 mm from each edge of the graft (Fig. 3). The size of the graft is mandatory because harvesting the graft with two metallic buttons increases the thickness such that a larger graft could not slide into a dedicated 15 mm cannula, and the exact position of the two holes was also important. The drill was placed through the superior cortex and exited the flattened cancellous side. The holes created corresponded to the distance of the cannulated drill sleeves previously placed in the glenoid neck. In one case, a substitute for bone graft was used. This xenograft (Osteoplant Bioteck SPA) was harvested from the proximal humeral epiphysis of the horse. The graft was completely deantigenated enzymatically, using Zimoteck. The graft can be pre-formed with the holes for the buttons, thus allowing greater precision and reduced operating times (Fig. 4).Fig. 3The tricortical clavicular graftFig. 4Left shoulder, anterior on the right and posterior on the left, scope from antero-superior portal. The preformed Xenograft (a) positioned on the glenoid anterior neck (b). (HH: humeral head, GL: glenoid, XG: Xenograft)