Latarjet Procedure for Shoulder Instability

Open Latarjet Procedure & Bone Grafting Surgeon

Are you an athlete who participates in contact sports? If so, you may be at risk of developing anterior shoulder instability. Patients who have frequent shoulder dislocations can develop loss of stability and may be ideal candidates for Latarjet surgery. Latarjet surgeon, Dr. Nikhil Verma provides diagnosis and both surgical and nonsurgical treatment options for patients in Dr. Nikhil Verma provides diagnosis and both surgical and nonsurgical treatment options for patients in Chicago who have developed recurrent anterior shoulder instability. Contact Dr. Verma’s team today!

What is the Latarjet procedure?

This innovative treatment offered by Dr. Nikhil Verma, is also known as the Latarjet-Bristow procedure and is named after the French surgeon who first described the procedure in 1954. It is used to treat shoulder instability and recurrent shoulder dislocations. Since shoulder instability is often caused by bone loss or a fracture of the glenoid (the socket portion of the shoulder joint,) Latarjet is used to restore the stability of the shoulder joint.

Who should have Latarjet for shoulder instability?

Patients in Westchester, Oakbrook, Hinsdale and surrounding Chicago communities, who experience recurrent severe shoulder dislocations or who have experienced bone loss in the front part of the shoulder socket, should ask Dr. Verma about Latarjet. For this type of shoulder instability, Latarjet procedure is the preferred method of treatment.

What happens during Latarjet surgery?

Dr. Verma will perform the Latarjet with an open incision in the shoulder. The goal of Latarjet is to augment the glenoid with additional bone to hold the head of the humerus within the shoulder socket more securely. The bone augmentation comes from the part of the scapula (shoulder blade) called the coracoid. Dr. Verma removes the coracoid from its original attachment site and moves it a few centimeters forward, to the front of the shoulder socket. Once in place, the coracoid is screwed into the shoulder socket.

Why would adding bone to the glenoid help shoulder instability?

The Latarjet procedure accomplishes two important tasks: First, it increases the amount of bone of the shoulder socket to restore bone that had been lost or damaged. Second, the muscles attached to the coracoid when it is relocated, create a sling to help support the shoulder in the front of the joint. For patients in Westchester, Oakbrook, Hinsdale and surrounding Chicago communities, the procedure is very successful at restoring stability to the shoulder joint. Dr. Nikhil Verma uses the Latarjet procedure as the preferred method for patients who have worn away at least 25% of their shoulder socket.

What is the recovery time after the Latarajet procedure?

Depending on the patient’s age, severity of bone loss and level of activity, the typical recovery time after Latarajet is approximately 4-6 months. Patients in Westchester, Oakbrook, Hinsdale and surrounding Chicago communities can expect the following recommendations from Dr. Verma:

• The arm will be placed in a sling following the repair and will be worn for 4-6 weeks to minimize movement and to protect the joint while it heals.
• Ice should be applied to the incision site to help alleviate swelling and pain.
• Dr. Verma will prescribe pain medications to be taken as directed.
• >The arm will need to be kept immobile in the sling, even when sleeping.
• Under the careful guidance of Dr. Verma’s time, patients will begin a specialized physical therapy program.
  • Passive range of motion exercises will be followed by active range of motion with a gradual strengthening regimen.
• Return to normal activities can be expected in about 5-6 months.

When is it best to have Latarjet surgery after an injury?

Latarjet surgery is often done when there is significant bone loss from the front of the glenoid region. Latarjet is not typically an emergency surgery performed after an injury, but more often recommended when a patient has experienced significant glenoid bone loss or multiple dislocations, or has failed a prior surgery to correct instability. The Latarjet proceedure is successful approximately 80-95% of the time in eliminating recurrent shoulder instability and dislocations.

How is the Latarjet procedure performed?

The Latarjet procedure is performed with a small incision in the front of the shoulder. The type of surgery depends on the amount of bone loss and shoulder damage. The procedure involves the following:

• An incision is made in the front of the shoulder.
• Verma will remove a piece of coracoid bone with the conjoined tendon (located at the front of the shoulder).
• The coracoid bone is moved to the front of the glenoid (socket.) This new piece of bone will be held in place with screws.
• The placement of the coracoid acts as a bone block which, combined with the transferred muscles acting as a strut, prevents further dislocation of the joint.
• The conjoined tendon also helps stabilize the shoulder by acting as a sling when the shoulder is abducted and externally rotated.

What is the rehabilitation after a Latarjet procedure?

After a Latarjet procedure, the patient will be placed in a sling or similar device for 4-6 weeks to protect the joint while it heals and to minimize movement. The sling is to be worn even while sleeping to avoid injury to the newly repaired joint. Patients can expect the following rehabilitation protocols after Latarjet surgery:

• Verma will prescribe pain medication to be taken during the healing process. It is important to take pain medications as directed by Dr. Verma
• Ice should be applied to the incision site to alleviate swelling and to help with pain.
• Keep the arm immobile – using a sling or similar device.
• Verma will recommend a specialized physical therapy program after about 5-6 weeks which will begin with passive range of motion exercises.
• Active range of motion exercises will follow and eventually, strengthening exercises.
• Patients are often able to return to full activities after about 3 months.

How long does a Latarjet procedure take?

The Latarjet procedure takes approximately 90 minutes to perform. It can be performed on an outpatient basis and patients may go home the same day.

What is the difference between Latarjet Procedure & Bankart repair?

Although both procedures treat shoulder instability and help with recurring shoulder dislocation, the two procedures are not a lot alike. The Latarjet procedure involves a bone graft and muscle/tendon transfer, where a Bankart repair reattaches a torn labrum and tightens the torn or stretched tendons of the shoulder. Each procedure can be highly beneficial, depending on the type of shoulder instability and the cause.