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Open stabilisation (Latarjet procedure)

This operation is performed to stabilise a shoulder where bone damage has occurred after traumatic shoulder dislocation(s). It is performed under general anaesthesia and nerve block as a day case, or with overnight stay.  An incision is made over the front of your shoulder. Your coracoid process is carefully cut from your shoulder blade. A split through muscle and capsule allows access to your shoulder joint. Your area of glenoid bone loss is prepared for the bone graft.  Your coracoid graft and its attached tendons is passed through the muscle split and screwed into place using two screws into your shoulder blade. This restores the bone loss and provides a muscle-sling at the front. Your wound is closed with dissolvable stitches.  The schematic below illustrates the key steps:


Schematic of Latarjet procedure. Completed procedure shown in 2 images on right – coracoid bone graft fixed to front of glenoid (socket) to reconstruct bone loss. Attached tendons work as a hammock for the humeral head to reduce further the dislocation risk

An Eden-Hybinette differs in that we use a bone block taken from your iliac crest (hip bone) rather than from the coracoid.  The bone block is fixed in the same way as the Latarjet graft and both operations work well.

What is my recovery after surgery?

You will come out of your sling between two and four weeks and increase to full range of movement exercises by six weeks. Strengthening will begin at about three months. All restrictions will be removed by six months.

In general you can expect to return to:

Office work after two to four weeks (in a sling)

Light physical work after eight to twelve weeks

Heavy labour may take 16-24 weeks

Contact sport usually takes six months

Driving - It will probably take six to eight weeks for you to be ready 

By six months, 95% of patients trust their shoulder

When will I be followed up?

You will be seen at two weeks after your operation. You will need follow up x-rays at six weeks and three months to assess healing of your graft.

What can go wrong?

Shoulder surgery is generally very safe. Specific risks of Latarjet stabilization surgery include:

Bleeding that needs a reoperation – rare (less than 1%)

Persistent stiffness (5%), but this rarely needs surgery

Screws in the joint requiring removal – very rare

Failure of bony union of the graft (up to 10%)

- It is important that your repair is protected during the early stages, hence the restrictions you’ll be given

- Stable non-bony healing may occur occasionally, this is fine

- Rarely, the graft displaces and revision surgery is needed

Re-dislocation/on-going instability symptoms

Most studies report failure rates below 5% for this surgery with excellent long-term outcomes and low rates of symptomatic arthritis

If you do develop recurrent instability, revision surgery may be required

Occasionally (5%) patients notice on-going pain in their shoulder