Latarjet Surgery

What is Latarjet surgery?

The Latarjet technique is a surgical procedure employed to treat recurrent shoulder dislocations and subluxations caused by boney defects or fracture of the shoulder socket including soft tissue damage. Surgical failure of soft tissue repairs such as a Bankart lesion is usually associated with significant boney defects or inadequate healthy soft tissue.

It is a well-known, safe and reliable technique to treat primary or recurrent dislocations or subluxation with or without ligament laxity and with or without glenoid bone loss. Using the Latarjet procedure improves the outcome of the repair of a Bankart lesion.

It may be performed arthroscopically or as an open procedure. Both approaches provide excellent clinical results with a low rate of recurrence. However, the open procedure is still considered to be the gold standard treatment for recurrent instability and dislocations.

Further, there are various modifications of the procedure that may be employed based on each patient' s needs.

When is the Latarjet surgery used?

It is used to treat recurrent anterior shoulder instability when conservative management fails. Anterior shoulder instability is common with first-time dislocation and recurrent instability is more likely to occur in young men with boney defects or ligament laxity. It can be so serious as to prevent the athlete from returning to sport.

Recurrent anterior shoulder instability is a complex disorder that mainly affects young men (late teens to mid-thirties) following a traumatic anterior shoulder dislocation; and generally, requires surgical intervention to restore joint stability. It is caused by forced shoulder rotation or dislocation whether by trauma or repetitive overhead activities.

The Latarjet procedure is the preferred procedure over arthroscopic Bankart lesion repair when there is glenoid bone loss. It may also be used to treat instability associated with rotator cuff tears in older patients. However, when the rotator cuff is not repairable the Latarjet procedure is contraindicated.

How is recurrent anterior shoulder instability diagnosed?

Dr. Johnston will take a detailed medical history and conduct a careful examination and testing of both shoulders comparing the heathy shoulder with the unstable shoulder. He will discuss your symptoms, when the shoulder was first dislocated, when recurrent instability began, the number of dislocations, the history of reducibility (putting the shoulder back in its socket), and whether the instability is multidirectional.

Who is a good candidate for Latarjet surgery?

Careful patient selection is a key to good clinical outcome and patient satisfaction.

Patients who have boney defects and recurrent anterior shoulder instability are prime candidates for the Latarjet procedure.

It is indicated for athletes who play contact sports and have suffered shoulder dislocations and instability and recurrent shoulder dislocations; and patients who have bone loss in the front of the shoulder due to trauma or repetitive overuse.

What happens during Latarjet surgery?

The goal of Latarjet surgery is to restore the basic anatomy of the shoulder joint. This is accomplished by augmenting the glenoid bone with additional bone so that the head of the upper arm bone is more securely held in its socket to prevent recurrent instability.

Bone is taken from a part of the shoulder blade called the coracoid. The coracoid is relocated to the front of the shoulder socket and screwed into place. This restores lost bone and when the coracoid is relocated the muscles and tendons of the coracoid create a sling-like support for the shoulder to prevent future instability and dislocation. Also, during surgery, Dr. Johnston can repair any labral tears, rotator cuff tears and shoulder capsule laxity.

When you or a loved one suffers with recurrent shoulder instability, you need a shoulder surgeon with the highest level of expertise for complex shoulder disorders. Dr. Peter Johnston is a board -certified shoulder specialist. His specialty is complex shoulder conditions. He is fellowship trained by some of the best surgeons in the country at the Rothman Institute at Thomas Jefferson University and he is located in southern Maryland. Contact Dr. Johnston to schedule a consusltation today.