Latarjet Procedure for Shoulder Instability
Occasionally, with shoulder instability, particularly if it is recurrent, the damaged capsule and labrum may be irreparably damaged. These tissues are essential for stability of the shoulder, preventing subluxation or dislocation of the shoulder. Additionally, with recurrent dislocations, the bone of the glenoid can be significantly worn away. In these conditions, the success of an arthroscopic stabilization may be compromised, leading to an eventual and likely failure leading to recurrent instability. Alternative procedures are then recommended.
Dr. Lenarz will perform the latarjet procedure which involves transferring a portion of the coracoid and attached tendons. The coracoid is a finger like projection of the front of the shoulder blade. This portion of the coracoid is transferred to the portion of the damaged glenoid and secured there with screws. This is done as an open procedure and is usually done as an outpatient. The procedure can be done at the hospital or an outpatient surgical center.
The most difficult part of the repair for the patient is the period of recovery, the initial immobilization and eventual progression of range of motion and strengthening. Failure to follow these recommendation and their timeline increases the risk of the bone being pulled away from the glenoid so it is unable to heal. This increases the risk or recurrence and further joint pain.
After the surgery, the patient will wake in the recovery room in a sling. If a “nerve block” was performed by the anesthesia doctor before the operation the arm will remain numb for 12-24 hours. This is usually done for post-operative pain control. Icing the shoulder should be done liberally. This can be through the use of ice in a bag, ice packs or a circulating ice water cooler. The dressing should not be removed and the patient may shower the day following surgery. The patient is asked to NOT scrub the incision but allow water to wash over the dressing.