The shoulder’s ball and socket structure provides it with the largest range of motion of any joint in the human body. The head of the humerus (ball) and the glenoid area of the scapula (socket) allow extreme mobility so patients can throw a ball, serve at tennis, and perform other overhead activities. With this mobility comes the risk of injury. Shoulder instability events, dislocations and subluxations alike, are quite common and cause patients to experience limited range of motion and pain. In cases where damage is too severe for an arthroscopic surgical approach, open stabilization surgery may be recommended by Dr. Matthew Provencher, orthopedic shoulder surgeon and sports medicine specialist serving the greater Vail, Aspen and Denver, Colorado area. This Latarjet procedure is typically reserved if a patient experiences anterior (to the front of the shoulder socket) bone loss during a dislocation, a dislocation that cannot be reduced, or chronic shoulder instability.
The shoulder joint is stabilized by a number of ligaments, cartilage and other soft tissue structures. When a shoulder dislocates, the injury can cause damage to these soft tissues, leading to a variety of complications. Patients may also experience damage to the bone or bone loss of the glenoid or of the humeral head, known as a Hill-Sachs lesion.
The initial treatment for all shoulder dislocations is for a medical professional to reduce the joint, or put the ball back in to the socket. Dr. Provencher will then perform a series of x-rays and an MRI scan to confirm the shoulder joint is back in the correct position, to look for extent of structure damage and to confirm the proper shoulder stabilization technique.
In certain patients, the damage after a dislocation may be so severe an arthroscopic approach may not correctly repair the injury. This may be because of bone loss during the dislocation, chronic instability, or a dislocation that cannot be reduced. Under these circumstances, an open shoulder stabilization technique is typically recommended by Dr. Provencher.
An open Latarjet procedure normally takes approximately 90 minutes, depending on injury severity and any other associated shoulder injuries. During the procedure, Dr. Provencher will create an incision at the front of the shoulder. Through the incision he will remove a piece of coracoid bone, located at the front of the shoulder, and move it to the front of the glenoid (socket). The new piece of bone will then be held in place with screws.
Open shoulder stabilization surgery replaces depleted bone, deepens the socket (glenoid), and moves several tendons at the front of the shoulder that act like a sling, treating chronic shoulder instability, and reducing the risk of future dislocations.
Recovery and Rehabilitation Following Open Shoulder Stabilization
Following open Latarjet procedure, the repaired arm will be placed in a sling or similar device for about 5-6 weeks to minimize movement and to protect the joint while it heals. Dr. Provencher usually recommends patients utilize ice packs and prescribed pain medications during the healing process to alleviate pain and swelling.
Patients will also begin a specialized physical therapy rehabilitation program under the guidance of Dr. Provencher and his orthopedic team. It is strongly suggested that patients work with the in-house physical therapists at Howard Head Sports Medicine to optimize their rehabilitation. The physical therapy program typically consists of gentle passive range of motion activities followed by active range of motion and strengthening exercises with a gradual return to full activities.
To learn more about open shoulder stabilization surgery, or to determine if you are a candidate for this Latarjet procedure, please contact Dr. Matthew Provencher, orthopedic shoulder surgeon in the Vail, Aspen and Denver, Colorado area.