Laterjet Procedure

What is Laterjet Procedure?

The shoulder joint provides a wide range of movement to the upper extremity, but injuries or repeated dislocations can cause instability in the joint. The Latarjet procedure is a surgical procedure performed to treat shoulder instability by relocating a piece of bone with an attached tendon to the shoulder joint.

When to Consider Latarjet Surgery

The Latarjet procedure may be recommended if you suffer from persistent instability, especially if you have already undergone shoulder reconstruction or a soft tissue stabilisation procedure that has been unsuccessful.

It may be considered before any other surgical techniques for athletes involved in high-contact sports such as rugby or football. It may also be the chosen procedure for you if you have a job that is physically demanding or requires working in an overhead position.

How Does the Latarjet Procedure Work?

Arthroscopic or keyhole surgery is a minimally invasive surgical technique that does not require a large incision carried out using specialized tools. The procedure will leave you with 2-4 minor scars on the back, side, and front of your shoulder. It is typically performed as a day case procedure, meaning you can go home on the day of your operation.

Open surgery is a traditional surgical technique where an incision is made using a scalpel so that the doctor has a full view of the structures and organs. This procedure involves an incision along the front of your shoulder and will leave a scar around 4-7 centimetres in length usually located along the top of your shoulder.

The Latarjet procedure aims to prevent shoulder dislocation and has been proven the most successful treatment, using both arthroscopic and open techniques. A general anaesthetic or a local anaesthetic and nerve block is used on the side of the affected shoulder to ensure you will not feel any pain during surgery, with the procedure taking approximately 90 minutes to 2 hours to perform. Your doctor makes a vertical incision and takes a bone graft from the shoulder blade (coracoid). They will then attach it to the front of the shoulder joint (glenoid) with two screws, increasing the distance the shoulder has to travel before it dislocates. The additional bone acts as a bumper to prevent and limit further dislocations. The transferred bone graft has a tendon attached that is then repositioned so it sits across the front of the shoulder creating an internal sling that should push the shoulder back into the joint when your arm is at risk. Your doctor will then stitch up any incisions made and dress the wound to keep it clean and prevent infection.

Post-Operative Recovery

If you undergo an arthroscopic Latarjet procedure you may be discharged within 3 hours following the operation; however, if you have an open surgery you may need to stay in the hospital for 2 nights. After surgery, you will be provided with a sling to be worn for around 6 weeks while the bone graft heals. For the first 3 weeks, you should wear your sling in bed to avoid stress on the shoulder and keep it stabilised. You will have a follow-up appointment to check that the wound is healing correctly. Any stitches used should dissolve or be removed or trimmed at around 3 weeks after the operation.

After surgery, you should:

• Avoid getting the wound wet for a week
• Avoid showering for 48 hours
• Take pain relief medication, as prescribed
• Not operate heavy machinery for 8 weeks
• Avoid driving for 4 weeks
• Avoid overhead sports for 4-6 months

Immediately following the surgery, your shoulder and arm often feel completely numb due to a nerve block being used during the operation; this can last for up to a few hours. You may also experience some pain or discomfort after the procedure but you will be given medication to help manage the pain whilst in the hospital; this can be continued when in recovery at home. Ice packs are also a useful technique to reduce pain. Ensure you protect the wound site to keep it dry until it is fully healed.