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\n\nShoulder instability is defined after 2 to 3 episodes of shoulder dislocation. A subluxation refers to a partial dislocation in which the joint spontaneously relocates.
\nIn addition to being very painful, shoulder instability causes functional limitation of the shoulder. Patients often experience significant apprehension during overhead or throwing movements (for example, serving in tennis or spiking in volleyball). As a result, they often limit their own movements, both in daily life and during sports activities.
\nIn cases of recurrent shoulder dislocation, the Latarjet procedure involves placing a bone block at the front of the glenoid (shoulder socket). First, this creates a physical barrier that prevents the humeral head from dislocating again. Second, the procedure repositions nearby tendons and muscles so that they act as an additional stabilizing sling, helping keep the humeral head in place during arm movements.
\nThe bone graft is taken through the same incision from the coracoid process, a small bony projection of the shoulder blade. It is therefore simply transferred a few centimeters to its new position.
\nThe Latarjet procedure is one of the two main surgical techniques, along with the Bankart procedure, used to treat shoulder instability.
\nThe risk of recurrence is generally lower after a Latarjet procedure. However, the Bankart procedure can often be performed arthroscopically, resulting in simpler recovery, faster functional improvement, and smaller, more cosmetic scars.
\nThe choice of surgical technique depends on your individual condition and will be discussed during your consultation with Dr. Roure. He will explain the advantages and disadvantages of each approach based on your specific situation.
\nThe Latarjet procedure is performed under general anesthesia. A one-night hospital stay is usually required.
\nThe operation begins with a vertical incision measuring approximately 5 to 8 cm at the front of the shoulder. The surgeon examines the shoulder joint and removes any damaged cartilage or injured labral tissue. Once the coracoid process has been harvested, it is secured with screws just in front of the joint surface. The joint capsule is then tightened to improve stability.
\nThe skin closure is performed using absorbable sutures placed beneath the skin (an intradermal running stitch), providing the best possible cosmetic result.
\nA Redon suction drain is usually placed and removed before discharge from the clinic.
\nFor the first two weeks after surgery, dressings should be changed every two days by a home nurse. Swimming and bathing are generally allowed afterward.
\nPain and occasional clicking sensations may persist for several months after surgery but usually improve progressively.
\nExternal rotation is generally the most difficult movement to regain. A small loss of motion compared to the opposite shoulder may remain.
\nAfter surgery, the arm is placed in a sling for approximately 4 weeks.
\nHowever, the arm remains free during the day, and the hand and elbow may be used immediately. Patients are simply asked not to lift the arm out to the side or perform rotational movements. In practice, the sling should be worn outdoors and at night to prevent accidental movements.
\nPatients must perform daily self-rehabilitation exercises, which will be taught by a physiotherapist before discharge from the clinic.
\nAt the end of the immobilization period, a structured physical therapy program begins. Rehabilitation typically lasts 1 to 3 months to optimize shoulder mobility and function.
\nJogging can generally be resumed after 6 to 8 weeks, as well as swimming (starting with breaststroke), followed by golf after approximately 2 months (putting initially).
\nReturn to gym training, tennis, and upper-body strengthening usually begins progressively after about 3 months. Contact sports can typically be resumed after 5 months, once shoulder strength and conditioning have been adequately restored.
\nThe risk of complications after Latarjet surgery is low, but they should nevertheless be considered before the procedure.
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