Arthroscopic Latarjet Procedure
What is the Latarjet procedure?
The Latarjet procedure was developed over 50 years ago by French surgeons to treat shoulder instability. It involves using a bone graft from the shoulder blade (coracoid) and attaching it to the front of the shoulder joint (glenoid) with the help of 2 screws.
The arthroscopic Latarjet procedure is the same procedure but performed through key-hole incisions using very specialised instruments.
How does the Latarjet procedure work?
The Latarjet is a very effective and robust method to prevent further shoulder dislocations. It works by two main ways. Firstly, the bone graft at the front of the shoulder effectively increases the distance the shoulder joint has to move before it dislocates, effectively creating a physical block to further dislocations. Secondly, the bone graft has a tendon still attached to it, effectively creating an internal sling across the shoulder that dynamically pushes the shoulder back into joint when your arm is in the overhead ‘at-risk’ position.
When should I consider a Latarjet procedure?
The Latarjet procedure should be considered if you have recurrent instability, especially if you have previously had a shoulder reconstruction or soft tissue stabilisation procedure (Bankart repair) that has now failed.
It should also be considered as a first line surgical option in patients who may not be stable enough after just a standard shoulder stabilisation or reconstruction procedure (Bankart repair). These include young patients, males, and those participating in high risk or contact sports (ie. football, rugby). It also includes patients who are deemed to have too much bone damage in their shoulder from previous dislocations. Performing only a standard soft tissue stabilization (Bankart repair) in this group of patients results in a high failure rate.
What are the advantages of an arthroscopic Latarjet procedure?
The advantages of an arthroscopic Latarjet over the open technique includes improved cosmesis, reduced pain and quicker recovery. It also allows the surgeon to deal with other problems in the shoulder through the same key-hole incisions (arthroscopic).
What is the recovery and rehabilitation after a Latarjet procedure?
After the surgery, you will be provided with a sling which is worn mainly for comfort. You may remove the sling for light activities and discard the sling completely after 2 weeks.
Rehabilitation after a Latarjet procedure is much quicker than after a standard shoulder
stabilisation/reconstruction (Bankart repair). A physiotherapist will guide you through the rehabilitation protocol. Full range of motion is allowed immediately while strengthening and resistance exercises are commenced after 6 weeks when the bone graft has healed.
When can I return to sport after a Latarjet procedure?
Return to sports after a Latarjet procedure is much quicker than after a standard shoulder stabilisation/reconstruction (Bankart repair). Being a bony procedure, healing is twice as quick as a soft tissue procedure eg. Bankart repair. Most patients are allowed to swim after 6 weeks, and return to full contact sports after 3-4 months.
What are the risks associated with a Latarjet procedure?
Complications are not common but can occur. Prior to making any decision to have surgery, it is important that you understand the potential risks so that you can make an informed decision regarding the advantages and disadvantages of surgery. The following list is by no means exhaustive, so it is important to discuss your concerns with your surgeon.
Specific risks of shoulder arthroscopy
Joint stiffness: There is a balance between keeping the shoulder in the sling while at the same time moving your shoulder enough to prevent a frozen shoulder. Your physiotherapist will guide you on how to prevent stiffness.
Nerve or vessel damage: There are small nerves under the skin that cannot be avoided and cutting them may lead to areas of numbness in the front of the shoulder. This area of numbness normally reduces in size with time and does not cause any functional problems with the shoulder. Very rarely there can be damage to important nerves or vessels in the arm.
Recurrent shoulder dislocation after repair: A repeat dislocation can still occur if you are unfortunate enough to suffer another significant injury or don’t follow the post-operative rehabilitation and resume contact sports too early before healing has occurred.
Failure of the bone graft to heal: Occasionally the bone graft may take longer to heal to the front of the shoulder or not heal completely. Patients at risk of poor healing include smokers and diabetics.
Other surgical risks include: risk of infection and bleeding, risk of arthritis, as well as problems with hardware (eg. screw breakage or the need to remove screws).
Apart from surgical risks, medical (including allergies) and anaesthetic complications can occur, and these can affect your general well being and health.
- Reconstructive Shoulder Surgery
- Arthroscopic Latarjet Procedure
- Total Shoulder Replacement
- Reverse Shoulder Replacement
- Shoulder Reconstruction
- Shoulder Arthroscopy
- Bicep Tendon Repair
- Arthroscopic Rotator Cuff Repair
- Arthroscopic Labral Repair
- SLAP Repair
- AC Joint Reconstruction
- Distal Biceps Tendon Repair
- Arthroscopic Capsular Release
- Arthroscopic Biceps Tenodesis
- Arthroscopic Excision of Calcific Tendinopathy
- Open Reduction and Internal Fixation of Fracture
- Arthroscopic Stabilization of Shoulder
- Arthroscopic Subacromial Decompression