Shoulder Surgery: Latarjet Anterior Stabilisation

Indications for operation

Recurrent traumatic instability

Anaesthetic

General Anaesthetic with an interscalene block (Fully asleep with a local anaesthetic injection into the side of the neck will numb the nerves to the shoulder for post-operative pain relief)

Operation type

Open

Incisions

A delto-pectoral incision. This is a 5 cm incision in the front of the shoulder running from just below the clavicle (collarbone) towards the axilla (armpit)

Procedure

After the incision has been made the joint is exposed using the delto-pectoral incision. The coracoid bone is detached and prepared then secured to the front edge of the geloind using 2 screws. The Bankart lesion (the area where the labrum has become detached) will be freshened up and the labrum reattached to the glenoid using 2 or 3 sutures secured to the bone using "suture anchors". The excess shoulder joint capsule will be tightened and secured with sutures.

Figure 1

normal shape glenoid

Figure 2

region of bone lost

Figure 3

appearance of damaged glenoid

Figure 4

coracoid transfered and secured

Arthrex animation of the Latarjet technique

Wound Closure

The wound will be closed with a single dissolving stitch running under the skin and paper stitches will be used over the top.

Dressings

Elastoplast dressings will be placed over the top of the paper stitches and an adhesive bandage over the top of all of the wounds.

Immediate aftercare

An immobiliser sling will be placed on the arm and it may feel numb for the rest of the day. You can go home when you feel comfortable and will be given instructions on what to do next.

Further instructions for Shoulder Stabilisation rehabilitation