How Our Groundbreaking Latarjet Procedure Repairs Shoulder Instability

Your shoulder joint is a ball-and-socket joint. It includes your upper arm bone (humerus) and the shallow cavity (the glenoid) of your shoulder blade.

The humeral head (ball) is supposed to stay close to the socket, and it’s held in place by the joint lining (capsule), ligaments, and a cartilage rim (labrum).

Shoulder dislocations, where the ball is forced out of the socket, are common injuries, especially in the young, active population. Unfortunately, after you’ve dislocated your shoulder once, recurrent dislocations become more and more common.

Some people have such severe instability in their shoulder that dislocations can occur with ordinary activities, or even while sleeping.

Every time your shoulder dislocates, you can sustain further damage to your joint. As a result, recurrent shoulder dislocations often call for a surgical repair to stabilize your joint and prevent future dislocations.

At Michael J. Bercik, Jr., MD, serving Lancaster County and the surrounding Pennsylvania communities, Dr. Bercik and our team offer Latarjet surgery to prevent repeated dislocations and the instability that comes with them. Here’s what you need to know about this groundbreaking procedure.

What is shoulder instability?

When you have significant trauma to a previously normal shoulder joint, your humeral head can be forcefully subluxed or dislocated. Subluxation occurs when your humerus (upper arm bone) partially slides out of place and back in quickly. This is also referred to as a partial dislocation.

A dislocation occurs when your upper arm bone comes all the way out of your shoulder joint cavity. It may go back into place over time, or it may need to be put back into place by a physician.

During both subluxation and dislocation, the capsule, ligaments, and/or labrum can be stretched, torn, or detached from your bone. After the head moves back in place, these structures may heal in a loose or stretched position, increasing your risk of future subluxations or dislocations.

With each additional event, your shoulder can sustain further tissue damage, increasing the tendency toward instability.

Damage to the shoulder joint

Typically, damage to your shoulder joint begins as a torn ligament the first time your shoulder pops out of the socket. This is known as a Bankart tear, and it’s very common in patients under 35.

During that initial dislocation, or with subsequent dislocations, other structures may sustain damage. Often cartilage or bone around the socket becomes damaged, and these injuries may be more difficult to repair.

When bone damage occurs, it may be to the ball or socket of your shoulder. Damage to the ball is known as a Hill-Sachs lesion. Damage to the socket causes fractures and bone loss to your glenoid bone (shoulder socket).

When your glenoid bone is damaged, the socket may progressively wear away, increasing your chance of recurrent dislocations. Glenoid bone loss can become so bad that you have a hard time keeping your shoulder in the socket.

What is the Latarjet procedure?

The Latarjet procedure was created in 1954 to augment a worn glenoid with additional bone. The bone, taken from your scapula (shoulder blade), is a hooked-shaped piece called the coracoid. It normally sits in the front of your shoulder blade and is the attachment point for several muscles.

During Latarjet surgery, your surgeon removes the coracoid from its normal location and moves it and the attached muscles a few centimeters to sit at the front of your shoulder socket. Once in position, your bone is screwed to your shoulder socket.

The Latarjet procedure accomplishes two major tasks: First, it increases the bone mass of your shoulder socket to restore what was lost. Second, the attached muscles create a sling to support your shoulder in the front of your joint.

The Latarjet procedure is highly successful at restoring stability to your shoulder joint, and, historically, was a standard treatment for people with shoulder dislocations. As newer surgical techniques have been introduced, the Latarjet is now seldom used for standard dislocations, instead reserved for patients who have at least 25% of their glenoid bone worn away.

Rehabilitation after Latarjet surgery lasts at least 4-6 months. The initial phases protect your shoulder sufficiently to allow for full bone healing. That means your mobility is restricted for the first few months while healing takes place. Next, therapists work with you to gradually increase the amount of shoulder motion, followed by progressive strengthening.

If you struggle with recurrent shoulder dislocations and instability, it’s time to come into the office of Michael J. Bercik, Jr., MD, to see if the Latarjet procedure can work for you. To get started, schedule a consultation at one of our three locations — Lancaster, Ephrata, and Mount Joy, Pennsylvania. Call us today or book an appointment online anytime.