The Latarjet procedure is a surgical technique used to treat shoulder instability, particularly in cases where there is significant bone loss in the shoulder socket (glenoid) or recurrent shoulder dislocations. This procedure involves transferring a portion of the coracoid bone, along with its attached tendons, to the front of the glenoid. This transfer helps to increase the stability of the shoulder joint, reducing the likelihood of future dislocations.
Why Consider the Latarjet Procedure?
Shoulder instability can be debilitating, especially if it results in repeated dislocations. When there is significant bone loss in the shoulder socket or when other stabilization procedures, such as arthroscopic Bankart repair, are unlikely to succeed or have failed, the Latarjet procedure may be recommended. This surgery is particularly beneficial for active individuals, including athletes, who require a stable shoulder for high-demand activities.
Who is a Candidate for the Latarjet Procedure?
The Latarjet procedure is typically recommended for:
- Patients with recurrent shoulder dislocations, especially if there is significant bone loss in the glenoid.
- Individuals who have failed previous shoulder stabilization surgeries.
- Athletes or individuals with high physical demands who need a stable shoulder joint.
- Patients with an engaging Hill-Sachs lesion, a condition where the head of the humerus is damaged due to repeated dislocations.
The Latarjet Procedure: Step-by-Step
The Latarjet procedure is a more complex surgery compared to other shoulder stabilization techniques. Here’s how it works:
- Incision and Exposure: The surgeon makes an incision at the front of the shoulder to access the glenoid and coracoid bone.
- Bone Transfer: A portion of the coracoid bone is carefully cut and transferred to the front of the glenoid. This bone graft is secured with screws, effectively increasing the size of the glenoid and providing a “bumper” that prevents the humeral head from dislocating.
- Muscle and Tendon Attachment: The tendons attached to the coracoid bone provide additional dynamic stability to the shoulder joint.
- Closure: The incision is closed with sutures, and the shoulder is bandaged.
The entire procedure typically takes about 1 to 2 hours, depending on the complexity of the case.
Recovery After the Latarjet Procedure
Recovery from the Latarjet procedure requires a well-structured rehabilitation plan to ensure the shoulder heals properly and regains full function. Key stages of recovery include:
- Immobilization: The shoulder is immobilized in a sling for the first few weeks to protect the surgical repair and allow the bone graft to heal.
- Physical Therapy: Physical therapy usually begins after the initial healing phase, focusing first on gentle range of motion exercises and gradually progressing to strength and stability training.
- Return to Activities: Most patients can return to daily activities within 3 to 4 months, though return to sports or heavy lifting may take 6 to 12 months, depending on the specific demands.
Benefits of the Latarjet Procedure
- Increased Stability: The primary benefit of the Latarjet procedure is the significant increase in shoulder stability, especially in patients with bone loss.
- Durable Results: This procedure provides long-term stability, making it ideal for patients with a history of recurrent dislocations.
- High Success Rate: The Latarjet procedure has a high success rate, particularly in active individuals and athletes.
