Sixteen percent of people suffer from shoulder pain and injuries, including instability and dislocations. In Lancaster, Ephrata, and Mount Joy, Pennsylvania, board-certified arthroscopic Latarjet surgeon Michael J. Bercik Jr., MD, offers cutting-edge arthroscopic Latarjet treatment to effectively address and treat shoulder instability, chronic shoulder instability, and ease discomfort related to shoulder dislocations and more. This guide is intended for patients seeking specialized surgical repair and expert care.
Schedule an evaluation with a Lancaster arthroscopic Latarjet surgeon by calling the office nearest you or using the online booking feature today.
What is Arthroscopic Latarjet?
Arthroscopic Latarjet is a minimally invasive surgical procedure that treats anterior shoulder instability or recurrent dislocations, often resulting from recurrent anterior shoulder instability and other shoulder injuries. This shoulder surgery technique is often necessary when there’s significant bone loss or a bony defect at the glenoid rim or damage to the cartilaginous rim, causing instability and frequent dislocations or chronic instability.
During the procedure, Doctor Bercik uses tiny incisions for minimal muscle trauma, arthroscopic portals, and a slender tubular device with an attached camera and light, typically performed with the patient in the beach chair position. This allows him to relocate a piece of the shoulder bone, known as the coracoid process (a small hook-like process), within the shoulder joint and shoulder socket.
When is the Arthroscopic Latarjet procedure needed?
Dr. Bercik, an arthroscopic Latarjet specialist, performs the arthroscopic Latarjet procedure when labral repair is not feasible or when patients experience frequent dislocations due to bone loss, fractures, or shoulder instability. Instead of repairing the torn labrum, he secures a bone graft, specifically, the transected coracoid process, into the glenoid fossa using screws. The graft includes the conjoint tendon, which helps prevent further anterior dislocation and improves shoulder function. This bone block reinforces the glenoid cavity, creating a barrier to dislocation and addressing instability in the glenohumeral joint, a ball-and-socket joint of the upper extremity involving the humeral head and long arm bone.
The key clinical threshold is approximately 20-25% glenoid bone loss. Below that level, a soft tissue repair such as a Bankart procedure may still hold. At or above it, the joint can no longer be stabilized through labral repair alone, and a bone block procedure becomes necessary. Dr. Bercik quantifies bone loss using CT imaging with 3D reconstruction of the glenoid before recommending surgery. This measurement drives the surgical decision, not symptoms alone.
Arthroscopic Latarjet vs. Bankart Repair: Why Bone Loss Changes Everything
When a shoulder dislocates and the labrum tears without significant bone damage, a Bankart repair reattaches the labrum to the glenoid rim and restores stability in most patients. That approach works when the underlying bone structure is intact.
The outcome changes when bone loss is present. A Bankart repair anchors soft tissue to a glenoid that no longer has the surface area to hold the humeral head in place. Clinical literature shows that recurrence rates after Bankart repair in patients with significant glenoid bone loss can exceed 20-30%, compared with failure rates below 5% after Latarjet in the same population. That gap is what drives the surgical recommendation.
The Latarjet procedure addresses the deficit structurally. The coracoid bone graft restores the width of the glenoid arc, while the attached conjoint tendon creates a dynamic sling across the front of the joint that actively resists anterior dislocation with every arm movement. This dual mechanism, bony reconstruction plus tendon sling, is why the Latarjet produces more durable stability than soft tissue repair in bone-loss cases.
As a shoulder specialist, Dr. Bercik evaluates each patient individually. Not every shoulder instability case requires a Latarjet, and the arthroscopic version is not always the right choice over an open approach. The recommendation is based on the measured degree of bone loss, the patient’s activity demands, and prior treatment history.
How should I prepare for Arthroscopic Latarjet surgery?
It’s essential to follow the Lancaster arthroscopic Latarjet doctor’s preoperative instructions for arthroscopic Latarjet surgery, and pain control options such as a nerve block may be discussed before the procedure. You may need blood work or imaging to ensure nothing interferes with surgery, especially when it comes to complex shoulder conditions. This could include scans to evaluate the glenoid surface, cup-shaped depression, or condition of the shoulder blade. Infection and nerve damage are rare complications but are considered in the preoperative planning.
You might need to pause certain medications or supplements, stop using tobacco, and fast as instructed. Plan for someone to drive you home after this relatively safe procedure.
What happens during an Arthroscopic Latarjet procedure?
Under anesthesia, Doctor Bercik, your shoulder surgeon, creates a few small incisions near the front of the shoulder to access the glenohumeral joint. Unlike the traditional open Latarjet procedure, arthroscopic Latarjet utilizes small surgical instruments and a slender tubular device with an attached camera.
The coracoid process is freed along with its attached tendons, including the conjoined tendon. It’s then passed through a separated subscapularis muscle and secured to the glenoid rim using screws, placed into previously drilled holes. This precise placement helps encourage bone healing and significantly improves shoulder stability, and supports the healing process.
Finally, the incisions are closed and covered with a sterile bandage at the surgical site. Graft position relative to the glenoid articular surface is one of the most technically demanding aspects of the procedure. The coracoid graft must sit flush with, not proud of, the joint surface to avoid accelerating cartilage wear. Dr. Bercik uses fluoroscopic confirmation of screw depth and graft alignment before closing, which reduces hardware-related complications and ensures the graft is oriented to consolidate with the native bone correctly.
What should I expect after Arthroscopic Latarjet surgery for shoulder instability?
After the procedure, you’ll rest in a recovery area while your vital signs are monitored. A friend or family member can drive you home. You’ll wear a shoulder sling for a few weeks to aid healing and help the shoulder heal properly. Temporary side effects may include swelling or pain, which can be eased with pain medications and ice packs.
Practice incision site care, keep the area clean, and avoid heavy activity to promote healing. Early motion exercises and passive-assisted range movements help prevent stiffness and improve range of motion. You may also begin strengthening exercises in a physical therapy program to restore function to the ball portion of the joint and improve movement in the socket joint.
Recovery Timeline and Milestones After Arthroscopic Latarjet
Recovery progresses in phases tied to graft biology, not just symptom relief. The coracoid bone graft must undergo osseointegration, the process of the transferred bone fusing with the native glenoid, before the shoulder can safely tolerate progressive loading. Pushing against that timeline is the most common reason recovery stalls.
Weeks 1 through 3 focus on graft protection. The arm remains in a sling, and active shoulder movement is intentionally restricted. Gentle pendulum exercises and distal joint movement at the elbow, wrist, and hand begin early to prevent stiffness and maintain circulation without stressing the fixation site.
Weeks 4 through 6 mark the transition out of the sling. Passive range of motion work advances under the supervision of a physical therapist. Most patients are cleared to drive during this window once they are off prescription pain medication and the shoulder has regained sufficient passive mobility.
Light weight-lifting exercises can begin at eight to twelve weeks.
Weeks 6 through 12 are the consolidation phase. Active motion and light rotator cuff activation begin, but resistance loading is kept low. Imaging during this period typically shows early radiographic evidence of graft incorporation. Dr. Bercik’s rehabilitation protocol is calibrated to protect the graft during this window, when it is mechanically vulnerable despite feeling improved.
Months 3 through 6 introduce progressive resistance, overhead movement, and sport-specific preparation. Full functional strength in the shoulder is typically restored by month five or six in patients who follow their protocol without interruption.
Return to Sport After Arthroscopic Latarjet Procedure
Published outcomes for arthroscopic Latarjet consistently show return-to-sport rates above 90% in athletic populations, with redislocation rates below 5% in appropriately selected patients. These figures represent a meaningful improvement over soft tissue repair in the presence of bone loss, where recurrence is substantially more common.
For non-contact recreational activities, most patients return between four and six months after surgery. Contact and collision sport athletes, including those in football, hockey, and wrestling, typically require 9 to 12 months before Dr. Bercik clears them for unrestricted competition. That timeline reflects the bone consolidation process, not pain or mobility alone. Returning to full contact before the graft has fully integrated increases the risk of hardware failure and graft displacement.
Overhead athletes, pitchers, tennis players, and competitive swimmers face additional demands around rotator cuff endurance and scapular control that extend their sport-specific rehabilitation before clearance. These patients work through a dedicated throwing or overhead program before returning to their sport.
How Michael J. Bercik Jr., MD, a Lancaster Arthroscopic Latarjet Surgeon Approaches Complex Shoulder Instability
A meaningful portion of Dr. Bercik’s shoulder practice involves patients who have already undergone instability surgery that did not hold. Revision instability cases are among the most complex in shoulder surgery because each prior procedure changes the anatomy and often accelerates bone loss. Dr. Bercik completed two international fellowships focused specifically on shoulder pathology, which included advanced training in revision reconstruction and complex instability cases.
For patients presenting with recurrent instability after a prior Bankart repair, evaluation begins with CT imaging to quantify current glenoid bone loss and MRI to assess soft tissue integrity. Many of these patients have developed additional bone loss since their original surgery, a factor that changes the reconstruction plan significantly compared to a first-time procedure.
In cases where both the glenoid and humeral head have sustained bone loss, a Hill-Sachs lesion on the humeral side combined with glenoid deficiency, the Latarjet alone may not be sufficient, Dr. Bercik, may combine the procedure with a remplissage technique to address the humeral lesion, or select an alternative reconstruction strategy based on the bipolar bone loss pattern. These decisions are discussed with patients directly, with imaging reviewed together so the anatomic rationale is clear.
Patients who have experienced multiple dislocations after a prior repair and are now considering revision surgery are encouraged to seek evaluation before additional dislocations occur. Each subsequent dislocation contributes to cumulative bone loss on both sides of the joint, narrowing the reconstructive options available.
Frequently Asked Questions About Arthroscopic Latarjet Surgery
Who is a candidate for arthroscopic Latarjet surgery?
Candidates typically have recurrent anterior shoulder dislocations with documented glenoid bone loss of 20% or more, a failed prior soft tissue stabilization such as a Bankart repair, or anatomy that makes labral repair unlikely to hold long term. High-demand athletes in contact or overhead sports with significant bone loss are also strong candidates. Dr. Bercik confirms candidacy through physical examination and CT imaging before recommending the procedure.
How much bone loss requires Latarjet instead of Bankart repair?
The widely used threshold is approximately 20-25% glenoid bone loss. Below that level, a Bankart repair can often provide adequate stability. At or above it, the glenoid surface area is insufficient to hold the humeral head in place through soft tissue repair alone, and a bone block procedure such as the Latarjet is indicated.
Is arthroscopic Latarjet better than open Latarjet?
Both produce comparable long-term stability outcomes when performed correctly. The arthroscopic technique avoids the larger deltoid-splitting incision required in the open approach, which reduces early postoperative pain and soft tissue disruption. The tradeoff is technical complexity — arthroscopic Latarjet is among the most demanding procedures in shoulder surgery; open Latarjet provides better visibility during surgery. Dr. Bercik determines the appropriate approach based on each patient’s anatomy and the complexity of their instability pattern.
How long does arthroscopic Latarjet surgery take?
The procedure typically takes 90 minutes to two hours. Patients go home the same day.
When can I drive after Latarjet surgery?
Most patients are cleared to drive between four and six weeks post-surgery, once the sling is discontinued and they are no longer taking prescription pain medication.
What is the failure rate of Latarjet surgery?
Redislocation rates after a correctly performed Latarjet in appropriately selected patients are consistently reported to be below 5% in the published literature. Hardware complications and graft non-union are uncommon but possible, and are more likely when patients return to high-impact activity before the graft has fully consolidated.
Can the Latarjet procedure address a Hill-Sachs lesion?
The Latarjet itself addresses glenoid-side bone loss. When a significant Hill-Sachs lesion is also present on the humeral head, Dr. Bercik may combine the Latarjet with a remplissage procedure, which fills the defect with soft tissue, or adjust the surgical plan based on the degree of bipolar bone loss. This is evaluated on imaging before surgery.
Is arthroscopic Latarjet covered by insurance?
The procedure is generally covered by major insurance plans when medically necessary, which typically requires documented shoulder instability, imaging evidence of bone loss or recurrent dislocation, and a record of prior conservative or surgical treatment. The office team can verify coverage before scheduling.
Contact a Lancaster Arthroscopic Latarjet Surgeon Michael J. Bercik Jr., MD
If you’re searching for the best shoulder surgeon in Harrisburg, Lancaster, Reading, or nearby communities, many patients turn to Dr. Bercik for care. Schedule an appointment for arthroscopic Latarjet surgery with Michael J. Bercik Jr., MD, by calling the office or requesting an appointment online today.
Along with Arthroscopic Latarjet surgery, Dr. Bercik manages shoulder conditions involving rotator cuff and tendon damage, joint wear, and limited mobility.
