With increasing shoulder instability events, the likelihood of a bony lesion of the glenoid and/or humeral head rises. Although bone loss of either the glenoid or humeral head may result in recurrent instability, bone injuries on both sides of the joint – or bipolar lesions have been shown, in particular, to result in a negative and additive effect on glenohumeral stability.  There are times that both the glenoid and the humeral head need to be reconstructed with bone graft.  We have shown that a combination of a fresh distal tibia allograft (for the glenoid) and a fresh talus (for the humerus) works well mechanically for stabilizing the shoulder joint.  This is my preferred technique for treatment of a severe bipolar lesion following a failed Latarjet procedure, made up of the application of a distal tibia allograft to address the glenoid bone loss and humeral head allograft to address the Hill-Sachs lesion.