The Latarjet Procedure

This is an open surgical procedure designed to stabilize the glenohumeral joint and prevent recurrent anterior shoulder dislocation.

This surgery is done under a general anaesthetic. Typically a shoulder arthroscopy is done as part of the same procedure to fully assess the shoulder joint. The aim of the procedure is to take the coracoid process (a 2×1 cm long piece of bone on which is attached part of the biceps) and transfer it though the subscapularis muscle onto the front of the glenoid. The Coracoid lies adjacent to the shoulder joint so this is all done via a 4-5 cm incision on the front of the shoulder. The bone block is secured in place using two screws. The capsule is repaired and maybe tightened if shoulder laxity is a problem.

Following surgery a drain is left in-situ for less than 24 hours. Dissolvable sutures are used. The wound should be kept clean and dry until removal of the dressings around day 14 after surgery. A sling is worn for the first 2-4 weeks. This can be removed in a safe environment ie at home. Gentle active range of movement is allowed without any speed or resistance.

Physiotherapy can start around week 8 to gently work on restoring range of movement. External rotation should be kept to 50% of the opposite side to allow for capsular healing until 12 weeks after surgery. Return to driving and running is allowed after 8 weeks. The biceps must be protected for the first 12 weeks. Lift nothing heavier than a cup of tea. Be careful of pulling up socks, closing doors, using the operated arm for support or using the arm near animals ie sheep or cattle. Sky diving or sport involving the arm is not permitted for the first 12 weeks. After 12 weeks to start strength and conditioning with physiotherapy aiming to return to all sport 4-6 weeks later. Complications are rare but may occur.

These include post-operative haematoma one in 50 patients. Rarely these will require return to theatre for washout. Recurrence of dislocation approximately 3%, infection 1/200, neurovascular injury transient 1/200, permanent 1/500. Screws rarely cause irritation and are removed in 1%, neuro vascular injury or other catastrophic failure 1:500. General medical problems related to anaesthesia are rare but can occur.