Latarjet

The Latarjet procedure is primarily used to treat recurrent anterior shoulder instability. This occurs when the shoulder repeatedly slips out of place toward the front of the body. Many patients first experience a shoulder dislocation during contact sports, a fall, or a traumatic injury.

After the initial dislocation, some patients continue to have instability episodes. The shoulder may fully dislocate again or partially slip out of place, known as subluxation. Repeated instability can lead to additional damage inside the joint.

The procedure is commonly recommended for patients with:

• Recurrent shoulder dislocations
• Chronic shoulder instability
• Bone loss of the glenoid socket
• Failed previous shoulder stabilization surgery
• High-risk athletes involved in collision sports
• Large bony Bankart lesions
• Engaging Hill-Sachs lesions
• Shoulder instability combined with ligament laxity

Athletes involved in football, wrestling, rugby, hockey, martial arts, and other contact sports are often candidates for the procedure because of the physical demands placed on the shoulder. The Latarjet procedure may also be considered for younger patients who have a high risk of recurrent dislocations due to the anatomy of their injury.

The procedure stabilizes the shoulder using three separate mechanisms. This is one reason it has become a highly successful option for difficult instability cases.

First, Dr. Kaplan transfers a small piece of bone called the coracoid process from one part of the shoulder to the front of the glenoid socket. This increases the size and depth of the socket, helping prevent the ball of the shoulder from slipping out.

Second, the transferred bone is secured with screws, creating a physical barrier that helps block future dislocations.

Third, the attached tendon acts like a sling across the front of the shoulder joint. When the arm is lifted or rotated, the tendon provides additional dynamic stability. Together, these effects help create a more stable and reliable shoulder.

The Latarjet procedure is performed under general anesthesia. Dr. Kaplan makes an incision near the front of the shoulder to access the unstable area of the joint, and evaluates the condition of the labrum, ligaments, cartilage, and bone inside the shoulder joint. If a patient also has a labral tear, he may repair the torn labrum during the same procedure. This helps restore additional stability to the shoulder.

Dr. Kaplan carefully moves a small piece of bone from the shoulder, along with attached tissue, to the front of the shoulder socket where bone loss or damage has occurred.

The transferred bone is secured into place with surgical screws to help make the shoulder socket larger and more stable. This added support helps prevent the shoulder from repeatedly slipping out of place.

Once the bone is positioned, he checks the shoulder to make sure the joint feels stable and moves properly before closing the incision.

The surgery usually takes about one to two hours depending on the severity of the instability and whether additional repairs are needed. Most patients return home the same day, although some may stay overnight for observation.

Recovery after the Latarjet procedure occurs gradually over several months. Most patients experience soreness, swelling, and stiffness during the early healing phase.

• After surgery, the arm is typically placed in a sling for several weeks to protect the repair. Patients are encouraged to move the elbow, wrist, and hand early, but shoulder motion is limited initially.
• Pain is usually managed with ice, medications, and rest during the first few days after surgery.
• Physical therapy is an important part of recovery. Rehabilitation progresses in stages to allow the transferred bone and soft tissues to heal properly.

Return to sports or physically demanding activities may take four to six months or longer depending on the individual and the demands of their activity. Contact athletes may require additional time before full clearance.

The Latarjet procedure has a strong track record for restoring shoulder stability and reducing the risk of future dislocations. Many patients are able to return to sports, exercise, and daily activities with improved confidence and function.

Most patients experience substantial improvement in shoulder stability and reduced feelings of looseness or apprehension. The procedure is particularly effective in patients with bone loss or failed prior stabilization procedures where other surgeries may have a higher risk of failure.

For patients with chronic instability and repeated dislocations, the Latarjet procedure can provide long-term shoulder stability and allow a safer return to an active lifestyle.