Shoulder Latarjet Procedure
The Latarjet procedure, also known as the Latarjet-Bristow procedure was developed over 50 years ago to treat shoulder instability. Each time the shoulder dislocates, additional damage can occur to the joint. If you suffer from recurrent instability, surgery may be an option to help stabilise the joint and prevent future recurring dislocations in the future.
Shoulder dislocations are common injuries often occurring in young, active people. If you dislocate your shoulder once or repeatedly, dislocations can occur more regularly. If you develop severe instability of the shoulder ball-and-socket joint, dislocation can occur with simple activities such as sleeping.
When to Consider Latarjet Surgery
The Latarjet procedure may be recommended if you suffer from persistent instability, especially if you have already undergone shoulder reconstruction or a soft tissue stabilisation procedure that has been unsuccessful.
It may be considered before any other surgical techniques for athletes involved in high contact sports such as rugby or football. It may also be the chosen procedure for you if you have a job that is physically demanding or requires working in an overhead position.
How Does the Latarjet Procedure Work?
Arthroscopic or keyhole surgery is a minimally invasive surgical technique that does not require a large incision carried out using specialised tools. The procedure will leave you with 2-4 minor scars on the back, side and front of your shoulder. It is typically performed as a day case procedure, meaning you can go home the day of your operation.
Open surgery is a traditional surgical technique where an incision is made using a scalpel so that the doctor has full view of the structures and organs. This procedure involves an incision along the front of your shoulder and will leave a scar around 4-7 centimetres in length usually located along the top of your shoulder.
The Latarjet procedure aims to prevent shoulder dislocation and has been proven the most successful treatment, using both arthroscopic and the open techniques. A general anaesthetic or a local anaesthetic and nerve block is used on the side of the affected shoulder to ensure you will not feel any pain during surgery, with the procedure taking approximately 90 minutes to 2 hours to perform. Your doctor makes a vertical incision and takes a bone graft from the shoulder blade (coracoid). They will then attach it to the front of the shoulder joint (glenoid) with two screws, increasing the distance the shoulder has to travel before it dislocates. The additional bone acts as a bumper to prevent and limit further dislocations. The transferred bone graft has a tendon attached that is then repositioned so it sits across the front of the shoulder creating an internal sling which should push the shoulder back into the joint when your arm is at risk. Your doctor will then stitch up any incisions made and dress the wound to keep it clean and prevent infection.
If you undergo an arthrosopic Latarjet procedure you may be discharged within 3 hours following the operation; however, if you have an open surgery you may need to stay in hospital for 2 nights. After surgery, you will be provided with a sling to be worn for around 6 weeks while the bone graft heals. For the first 3 weeks, you should wear your sling in bed to avoid stress on the shoulder and keep it stabilised. You will have a follow-up appointment to check that the wound is healing correctly. Any stitches used should dissolve or be removed or trimmed at around 3 weeks after the operation.
After surgery, you should:
- Avoid getting the wound wet for a week
- Avoid showering for 48 hours
- Take pain relief medication, as prescribed
- Not operate heavy machinery for 8 weeks
- Avoid driving for 4 weeks
- Avoid overhead sports for 4-6 months
Immediately following the surgery, your shoulder and arm often feel completely numb due to a nerve block being used during the operation; this can last for up to a few hours. You may also experience some pain or discomfort after the procedure but you will be given medication to help manage the pain whilst in hospital; this can be continued when in recovery at home. Ice packs are also a useful technique to reduce pain. Ensure you protect the wound site to keep it dry until it is fully healed.
Risks and Complications
Complications are rare but can occur. It is important that you understand the potential risks prior to making the decision to undergo surgery. Risks include:
Even though you will be in a sling, it is important to move the shoulder to avoid frozen shoulder. The physiotherapist will inform you on how to prevent stiffness.
Nerve or blood vessel damage
Numbness may occur in the front of the shoulder due to the cutting of small nerves under the skin. The numbness usually reduces in size and does not cause function problems with the shoulder.
Recurrent shoulder dislocation after repair
A repeat dislocation may still occur if you sustain a significant injury or do not follow the rehabilitation advice after your surgery and resume contact before healing has complete.
Failure of the bone graft to heal
In some cases, the bone graft may take longer to heal at the front of the shoulder or not at all. This is more likely to occur if you smoke or suffer from diabetes.
Other surgical risks include:
- Bleeding or blood clots
- Risk of arthritis
- Screws breaking
- Anaesthetic complications
Outlook after Surgery
After having surgery, patients should understand that the majority do not gain normal range of motion after their procedure; however, this is usually acceptable given the improvement in the stability of the joint.
At One Healthcare we can book you in to see a specialist Orthopaedic Shoulder and Elbow surgeon, usually within 48 hours, for an initial consultation. The Shoulder Latarjet Procedure is available at One Ashford Hospital in Kent and One Hatfield Hospital in Hertfordshire.
You can use your private medical insurance or pay for your Shoulder Latarjet Procedure treatment. We offer competitive, fixed price packages as well as the ability to spread your cost with the option of 0% finance. If you are using your health insurance please do contact your insurer first for approval and let them know you’d like to be treated at either the One Ashford Hospital or One Hatfield Hospital.
Why One Healthcare
- Modern purpose-built hospital opened in March 2016 (Ashford) December 2017 (Hatfield)
- Fast access to diagnostics including MRI, Xray and Ultrasound
- Private, spacious, en-suite rooms
- Specialist Physiotherapy and nursing teams
- Little or no waiting time
- ‘Ultra clean air’ theatres
- Freshly prepared food
- Calm, dignified experience
Mr Jai Relwani
Consultant Orthopaedic Surgeon; Clinical Lead - Shoulder & Elbow Service
One Ashford Hospital
Mr Rajeev Sharma
Consultant Orthopaedic Surgeon - Upper Limb Surgery (Shoulder, Elbow, Wrist and Hand)
One Hatfield Hospital