If you’ve experienced the sensation of a dislocated shoulder, you probably hope that’s the only time you have to experience that feeling. Unfortunately, a shoulder dislocation oftentimes injures or weakens the supportive soft tissues that hold the shoulder joint in place, meaning a shoulder dislocation only increases your risk of subsequent dislocations. Many patients find that they end up dislocating their shoulder a few different times before they realize that they need to have the problem managed with the help of an orthopedic specialist.
Your specialist may recommend a healthy dose of physical therapy exercises to strengthen the affected soft tissues, but for severe damage or for patients who have dealt with multiple dislocations, surgery may be the optimal route forward. For these patients, they may be best suited for the Latarjet corrective procedure. We dive into the Latarjet procedure for shoulder instability correction in today’s blog.
Understanding The Latarjet Procedure
The Latarjet procedure was first introduced in 1954 by a French surgeon named Dr. Michel Latarjet who first performed the operation as a way to address chronically unstable shoulders. Nowadays it is widely considered the most effective way to treat anterior shoulder instability stemming from damage or bone loss to the shoulder socket (the glenoid).
To understand why the Latarjet procedure is so effective, we first must understand more about the composition of the shoulder joint. Your shoulder is a ball-and-socket joint that is made up of three bones – the humerus, the scapula and the clavicle. Muscles and tendons around the shoulder stabilize and support the area. The end of the humerus, known as the humeral head, fits into the glenoid socket part of the scapula, but it needs to be held in place by the rotator cuff, which is a collection of strong soft tissues. If these soft tissues become overstretched or damaged, the humeral head can pop out of the glenoid socket, leading to significant pain and dysfunction. Even after the joint is reset, the damage to the supportive ligaments and tendons or problems with the glenoid socket can leave the shoulder feeling unstable and prone to recurrent dislocations.
The Latarjet procedure addresses the main issues going on under the surface in patients dealing with recurrent dislocations. During the procedure, the surgeon will make a small incision on the front of your shoulder blade. They will then excise a small piece of bone, known as the coracoid bone, from your shoulder blade and attach it to the front of your shoulder socket where your socket bone has worn down. This coracoid bone acts like a latch on a gate, providing extra stability and holding the humeral head in the correct position. Your surgeon will also attach small tendons to the coracoid bone to add even more stability so that you’ll eventually be able to move your arm in directions that were likely to cause a dislocation prior to your procedure. Many patients are again able to raise their arms in front of their body or over their head without fear of dislocation thanks to the extra support provided by the coracoid bone.
Best of all, the coracoid bone is in a position such that transferring it to the anterior area of the shoulder socket will not compromise any shoulder function. Special bone wax is inserted into the area where the bone was excised which ensures adequate healing of the surgical site.
The Latarjet procedure is beneficial for any patient who is dealing with chronic instability or frequent dislocations due to anterior shoulder instability, but it can be especially helpful for athletes, manual laborers and frontline workers who require shoulder mobility as part of their daily activities. Many of these patients find that the Latarjet procedure provides significant symptom relief and fully addresses their instability. In fact, data shows that only about five percent of patients will suffer another shoulder dislocation within five years following a Latarjet correction.
So if you’ve been bothered by frequent shoulder dislocations or your shoulder feels unsteady and unstable, it’s time to learn more about your treatment options. Whether you’ll need a short course of physical therapy or a more hands-on treatment, Dr. Holloway and his team will be here for you. For more information, or for help with a different shoulder issue, connect with our team today at (865) 410-7887.
