Latarjet Procedure

Recurrent shoulder dislocations can cause not only limitations in sports but also functional restrictions and a persistent sense of instability in daily life.

The Latarjet procedure is a surgical method performed in patients with recurrent shoulder dislocation associated with glenoid bone loss.

In this technique, a piece of bone called the coracoid process is transferred and fixed to the front of the glenoid socket. This provides additional bony support and prevents further dislocations.

In patients with more than 15% bone loss of the glenoid rim, soft tissue procedures such as arthroscopic Bankart repair or remplissage may be insufficient, and dislocation may recur. In such cases, the Latarjet procedure is a reliable solution to restore shoulder stability.

What Is Recurrent Shoulder Dislocation?

Recurrent shoulder dislocation occurs when, after the first traumatic dislocation, the shoulder tends to dislocate again with lower-energy movements.

This condition is usually anterior (forward) in direction. With each dislocation, damage to the capsule, labrum, and bone structures increases.

• After the first dislocation, patients often develop a Bankart lesion (labral tear) and a Hill-Sachs lesion (compression fracture of the humeral head).
• These structural injuries weaken the stability of the joint, predisposing the shoulder to repeated dislocations.
• The risk of recurrence is especially high in young, active individuals who sustain their first shoulder dislocation at an early age.

Recurrent dislocations are not only due to soft tissue laxity but also frequently associated with glenoid bone loss.

In such cases, soft tissue repair alone is insufficient, and bone augmentation procedures such as the Latarjet procedure are required.

Who Is a Candidate for the Latarjet Procedure?

The Latarjet procedure is primarily indicated in patients with recurrent anterior shoulder dislocations combined with significant bone loss.

When the glenoid rim is deficient, soft tissue repairs (such as Bankart repair) may fail, making bone transfer procedures necessary.

The Latarjet procedure is especially recommended for:

• Patients with glenoid bone loss greater than 15%
• Patients with recurrent dislocation after Bankart repair
• Patients with engaging Hill-Sachs lesions where remplissage would not be sufficient
• Athletes involved in contact sports (e.g., football, wrestling, basketball)
• Patients with generalized hyperlaxity or connective tissue insufficiency where soft tissue repair alone is inadequate

For this group, the Latarjet procedure provides both bony support and dynamic stabilization, making it an effective and reliable treatment.

Why Is the Latarjet Procedure Effective in Recurrent Shoulder Dislocation?

The effectiveness of the Latarjet procedure is based on the so-called “triple blocking effect”, which provides both static and dynamic stability:

Bone Block Effect

The coracoid process is transferred and fixed to the anterior glenoid, increasing the articular surface and mechanically preventing the humeral head from slipping forward.

Dynamic Stabilization (Sling Effect)

The conjoint tendon (short head of the biceps and coracobrachialis), attached to the coracoid, provides dynamic support to the front of the shoulder, particularly when the arm is in external rotation.

This enhances shoulder stability during motion.

Capsular Tensioning

The joint capsule is passed over and secured behind the bone graft, tightening the anterior capsule and improving passive stability.

Through these three mechanisms, the Latarjet procedure restores stability in cases of significant glenoid bone loss, making it one of the most reliable surgical options for recurrent anterior shoulder dislocation.

How Is the Latarjet Procedure Performed?

The Latarjet procedure is an anatomical stabilization surgery in which the coracoid process is transferred to the anteroinferior part of the glenoid to provide bony support.

Although it is most commonly performed with the open technique, some surgeons also perform it arthroscopically.

Main Steps of the Procedure

• Preparation of the coracoid process: The coracoid process, located on the anterior scapula, is mobilized along with its attached muscles (especially the short head of the biceps and coracobrachialis). A 2–2.5 cm bone fragment is osteotomized and prepared.
• Splitting of the subscapularis muscle: To reach the anterior shoulder, the subscapularis muscle is split longitudinally, and the joint capsule is opened to expose the anterior glenoid.
• Fixation of the coracoid to the glenoid: The prepared coracoid graft is fixed to the glenoid rim (typically at the 3–5 o’clock position) with two screws or specialized fixation devices. This provides both increased articular surface and dynamic stability through the attached muscles.
• Capsular repair (if needed): In some cases, the capsule is also repaired to further reinforce the anterior shoulder.

The operation lasts approximately 60–90 minutes and is usually performed under general anesthesia. The open technique allows direct visualization and more controlled graft placement for the surgeon.

Recovery After Latarjet Surgery

To protect the shoulder after surgery, a sling is used for about 4–6 weeks.

Rehabilitation begins early and typically progresses as follows:

• Initial phase: Pain control and passive range of motion exercises.
• Intermediate phase: Active range of motion and isometric strengthening.
• Advanced phase: Progressive strengthening and neuromuscular control of the shoulder.
• Return to overhead or high-demand sports (e.g., basketball, volleyball, swimming) generally takes 4–6 months.

Risks and Complications of the Latarjet Procedure

As with any surgery, the Latarjet procedure carries some risks and potential complications:

• Nonunion: Failure of the coracoid graft to fuse with the glenoid.
• Screw-related problems: Loosening or irritation of fixation screws.
• Neurovascular injury: The musculocutaneous and axillary nerves are at risk.
• Shoulder stiffness: Especially external rotation limitation.
• Infection or hematoma: Rare but possible.
• Recurrent dislocation: May occur if the wrong indication or poor technique is applied.

When performed by experienced surgeons and with correct indications, complication rates are low.

Frequently Asked Questions About the Latarjet Procedure

For more information or to book an evaluation with Op. Dr. Utku Erdem Özer, please Contact Us.