Latarjet Procedure

The Goal

Dr. Kevin Wall provides specialized, fellowship-trained surgical treatment for the Latarjet Procedure to restore function and relieve pain for patients in Richmond, VA, and the surrounding Central Virginia communities. The goal of this procedure is to treat recurrent shoulder instability in patients with significant anterior glenoid bone loss (where the socket has worn away). While a standard labrum repair (Bankart) reattaches soft tissue, it often fails if the underlying bone "platform" is missing. The Latarjet procedure restores this platform by transferring a piece of your own bone (the coracoid process) to the front of the socket. This creates a "triple-effect" of stability: increasing the bone surface area, creating a "sling effect" with the attached tendons, and repairing the joint capsule. It is a powerful option, especially for young athletes, who have bone loss but a thorough evaluation with MRI and CT is necessary. A conversation with Dr. Wall about the most appropriate option for you is always important as other options such as glenoid reconstruction with a bone graft must also be considered.

This page is designed to educate you specifically about this procedure. Additional information that generally applies to most of Dr. Wall’s surgeries can be found on these pages:

The Procedure

  • The Approach: Performed through an open incision on the front of the shoulder to allow for precise bone grafting and secure fixation.

  • Coracoid Transfer: The coracoid process—a small "hook" of bone in the front of the shoulder—is carefully detached along with the attached conjoined tendon.

  • Socket Preparation: The front of the shoulder socket is prepared to create a flat, fresh surface that will allow the new bone to fuse.

  • Rigid Fixation: The coracoid bone is shifted into the defect on the socket and secured with two high-strength compression screws. The defect that used to allow the humeral head to shift and dislocate is now filled.

  • The Sling Effect: The conjoined tendons now cross the front of the joint, acting as a dynamic "hammock" or sling that physically prevents the shoulder from sliding forward when the arm is in a throwing position.

Post-Op Protocol

  • Phase 1 (0–6 weeks): The sling must be worn at all times, except for hygiene, formal physical therapy, and elbow motion. Pendulum exercises are permitted immediately. You may perform active range of motion for the elbow, wrist, and hand. Specific restrictions during this phase include no active shoulder motion (AROM), no weightbearing, and no pushing or pulling. External rotation is strictly limited to neutral (0 degrees) to protect the repair. PT is started immediately to teach safe motion and the restrictions.

  • Phase 2 (6–8 weeks): You will begin weaning from the sling and can resume daily living activities such as washing, dressing, and driving. Therapy progresses through passive, active-assisted, and active range of motion (PROM/AAROM/AROM). Gentle passive external rotation is allowed as tolerated, and scapular strengthening is initiated.

  • Phase 3 (8–12 weeks): The focus during this period is to achieve full range of motion in all planes. Formal shoulder strengthening exercises begin.

  • Phase 4 (12–20 weeks): Strengthening exercises continue to progress. A CT scan is obtained at 16 weeks post-operatively to evaluate the degree of bone healing.

  • Phase 5 (20+ weeks): You may return to labor-intensive work or non-collision sports if the 16-week CT scan confirms adequate healing. A full return to collision sports typically occurs at the 6-month (24-week) mark.

When to Seek Care

You should schedule a consultation if:

  • You have "bone loss" or a "bony Bankart" lesion that makes a standard soft-tissue repair likely to fail.

  • Your shoulder continues to dislocate or feel unstable even after a previous labrum surgery.

  • You are a high-level collision athlete (football, rugby, wrestling) with recurrent anterior instability.