 Bone graft performance is one of the most important factors for successful glenoid reconstruction to treat anterior shoulder instability. Although distal tibial allografts are gaining popularity over the more commonly used coracoid onografts, many orthopedic surgeons remain concerned about the potential for decreased healing and increased resorption when using allograft bone. To address these concerns, researchers compared patient radiological outcomes in the context of both graft types following glenoid reconstruction to treat anterior shoulder instability with significant glenoid bone loss. Their results suggest that tibial allografts are a promising option to recreate glenoid bony morphology. To reach this conclusion, the team retrospectively reviewed the radiographic findings from 36 patients who underwent tibial allograft and 12 patients who underwent coracoid autograph procedures to manage anterior shoulder instability with glenoid bone loss. Two fellowship-trained musculoskeletal radiologists assessed graft position, glenoid concavity, cross-sectional area, width, version, total cross-sectional area, oseous union, and graft resorption at a follow-up of eight months, and clinical outcome in terms of instability was also assessed after two years. For nearly all measures, the distal tibial allograft showed comparable radiological and clinical outcomes to the coracoid autographs. Although there were no significant differences between the procedures for bone union or glenoid measurements, the coracoid autographs were more likely to result in a lateral step formation. This could be because the coracoid is round and completely composed of bone, whereas the distal tibia is flat and has a cartilage surface, potentially leading to better positioning. Step formation has been tied to the occurrence of osteoarthritis, so avoiding this may help prevent this outcome. The other main difference between the two graft types was related to bone resorption. The tibial allograft showed significantly higher rates of resorption than the coracoid autographs. Despite the higher resorption in the allograft patients, the final graft size for both groups was equal. It's possible the allograft showed greater resorption because the initial graft size was larger than that of the autographs. Overall, these findings revealed the unique advantages of using tibial allografts for glenoid bone reconstruction. Although additional studies are needed to track the longer term performance of both graft types, it seems that tibial allografts are a promising alternative for patients requiring surgical management of shoulder instability.