The Latarjet procedure is an open operation to treat recurrent shoulder dislocations by transferring a piece of bone (coracoid process) with its attached muscles to the front of the shoulder socket. It is used when there is significant bone loss from the socket or when arthroscopic Bankart repair has failed.
An incision is made over the front of the shoulder. The coracoid process (a small bony projection) with the attached conjoint tendon is cut and transferred to the front of the glenoid (shoulder socket), where it is fixed with two screws. This creates a bony block that prevents the humeral head from dislocating and the transferred muscles provide a dynamic sling effect. The operation takes one and a half to two hours.
The Latarjet is recommended for recurrent shoulder instability with significant glenoid bone loss (typically more than 15-20%), failed previous Bankart repair, instability in collision athletes or military personnel, and engaging Hill-Sachs lesions.
Physiotherapy for muscle strengthening and proprioception, activity modification, and bracing. Arthroscopic Bankart repair is the main surgical alternative when bone loss is minimal.
CT scan to quantify glenoid bone loss. Standard pre-assessment.
The Latarjet has a recurrence rate of approximately 2-5%, which is lower than arthroscopic Bankart repair. It is particularly effective in patients with bone loss and contact athletes.
Some reduction in external rotation is expected. Usually 10-15 degrees and rarely functionally significant.
Temporary shoulder stiffness improving with physiotherapy.
Visible scar over the front of the shoulder.
The transferred bone may fail to heal in its new position. Risk approximately 5%.
Musculocutaneous and axillary nerves are at risk. Usually temporary.
May require removal.
The coracoid may fracture during transfer.
Despite surgery, approximately 2-5% risk.
Long-term risk if screws protrude into the joint or the graft is over-medialised.
General anaesthesia with a nerve block.
Sling for four to six weeks. Gentle exercises from the first week. Active movement from six weeks. Strengthening from three months. Return to non-contact sport at three to four months. Contact sport at six months. Full recovery six to nine months.
Reviews with X-rays at two weeks, six weeks, three months, and six months.
The Latarjet is chosen when there is significant bone loss from the socket, as a Bankart repair alone has a higher failure rate in this situation. The bone block restores the socket anatomy.
Yes, the Latarjet is particularly effective for contact athletes. Return to contact sport is typically at six months.