Latarjet Procedure for Shoulder Instability in Adelaide

The Latarjet procedure is a type of shoulder stabilisation surgery. It is most commonly used for recurrent shoulder dislocations, especially when part of your shoulder socket has lose some bone.

The procedure involves transferring a small piece of bone, called the coracoid, from your shoulder blade (scapula) to the front of the shoulder socket (glenoid). The bone is then secured in position using screws. This increases the width of your socket, restores any bone loss and helps in stabilising your shoulder. 

The tendons attached to the coracoid also provide additional stability. The attached tendons acts like a sling, offering additional dynamic support, particularly during activities that would typically cause dislocation.

The Latarjet procedure aims to improve shoulder stability and reduce the likelihood of further dislocations. However, the operation is not necessary for every patient with shoulder instability. 

Your shoulder allows a large range of movement, but this mobility also makes it more susceptible to dislocation.

A shoulder dislocation can damage the labrum, ligaments and capsule that help maintain stability. Repeated dislocations may also cause bone loss from the front of the glenoid.

Instability commonly occurs following an injury. Dislocations with sport are especially frequent. During contact or team sports such as AFL, rugby, soccer or basketball your shoulder is subjected to substantial loading which can lead to instability.

Some patients experience repeated complete dislocations. Others describe that their shoulder partially slips out, feels insecure or cannot be trusted during certain movements.

The Latarjet procedure improves shoulder stability through two main mechanisms.

Bone Transfer

The coracoid bone graft is transferred to the front of the glenoid. This widens the glenoid, restores any bone loss and helps tighten the front of your shoulder.

The wider socket provides additional bony support and reduces the tendency for your humeral head to move out of the socket.

Dynamic Sling Effect

The tendons attached to the transferred coracoid remain connected to their muscles. As your arm moves, they provide additional dynamic support to the front of your shoulder. This becomes particularly important in positions that would usually lead to a dislocation.

Shoulder instability can be treated with shoulder arthroscopy (arthroscopic Bankart repair) and the Latarjet procedure. While both procedures aim to restore stability, they achieve this by different techniques. 

An arthroscopic Bankart repair uses small incisions to reattach the damaged labrum and supporting tissues to your shoulder socket. It is partiularly effective when bone loss is limited and the surrounding structures are suitable for repair.

The Latarjet procedure transfers bone to the front of the glenoid. This is more suited to your shoulder if you have substantial bone loss or other risk factors make a soft tissue repair less reliable.

The most suitable operation depends on your individual shoulder anatomy, injury pattern and risk of recurrent instability. Dr Arthur Turow will discuss this with your during your consultation. 

The Latarjet procedure is done under general anaesthesia. A regional nerve block may also be used to help manage pain immediately after surgery.

In an open Latarjet procedure, an incision is made at the front of your shoulder. The coracoid process is prepared and transferred to the front of the glenoid, where it is secured with titanium screws.

Your shoulder stability is then checked and the position of the graft confirmed using intra-operative X-Rays. Your incision is then closed and waterproof dressings applied. 

Following surgery, your arm is placed in a sling to protect the repair while the bone graft heals.

Dr Turow is an Australian-trained orthopaedic surgeon with a subspecialty focus on shoulder and upper limb surgery, including shoulder instability and reconstructive surgery. He is a Fellow of the Royal Australasian College of Surgeons and a member of the Australian Orthopaedic Association. He also holds a Master of Surgery and is a clinical lecturer with the University of Adelaide.

Treatment begins with an assessment of your injury, examination and imaging. Dr Turow will discuss with you the extent of any glenoid bone loss, associated injuries and the factors that may influence the risk of further dislocations.

Consultations are available in Adelaide CBD and at regional locations across South Australia, including Yorke Peninsula, Gawler and Mt Barker. 

Read more about Dr Turow and his training. 

Recovery occurs in stages with assistance by your physiotherapist. Dr Arthur Turow will guide you during your rehabilitation.

The Latarjet procedure can provide reliable shoulder stability but complications can occur.

Potential risks include infection, bleeding, nerve injury, stiffness, persistent pain, loss of movement, graft nonunion or absorption, screw-related problems and recurrent instability. Some complications may require further surgery.

Dr Turow will discuss your expected benefits, risks and alternative treatment during your consultation.