Rehabilitation guidelines for open latarjet anterior. Latarjet shoulder stabilisations the sports injury and. A dislocated shoulder, which is different from a separated shoulder, occurs when the head of the humerus bone pops out of the shoulder joint. This procedure is mainly performed when there is some bone loss from the front of the glenoid as a result of a bony bankart lesion or repeated dislocations wearing away the front of the glenoid. Latarjet protocol the intent of this protocol is to provide the clinician with a guideline of the postoperative rehabilitation course of a patient that has undergone a latarjet procedure for anterior stabilization. Preoperative rehabilitation is advisable prehab day 1 3 weeks. Prom as instructed restrictionsexercise progression. Modified latarjet procedure for patients with glenoid bone defect accompanied with anterior shoulder instability article pdf available in acta orthopaedica et traumatologica turcica 476. Shoulder dislocation surgery the latarjet procedure. How does the latarjet procedure work shoulder surgery. The latarjet operation was first described by a french surgeon dr michel latarjet and has been used very successfully to reconstruct shoulders with recurrent anterior instability. Shoulder stability in healthy individuals is achieved through the structural integrity of the noncontractile nonmuscle shoulder stabilizers ligaments, capsule and labrum and function of the rotator cuff and scapular muscles. Sling immobilization with supporting abduction pillow to be worn at all times except for showering and rehab under guidance of pt.
Postoperative protocols this rehabilitation protocol has been developed for the patient following an open bankartlatarjetcoracoid transfer surgical procedure. You shouldnt have your shoulder dictate your daily life. Once the dressing is removed on the first or second day, ice is applied for 20minute periods 34 times per day. While the postop dressing is in place, icing should be done continuously. The effect of a glenoid defect on anteroinferior stability of the shoulder after bankart repair. The latarjet operation for shoulder reconstruction the latarjet operation was. Longterm results of the latarjet procedure for the. We compared patients with recurrent posttraumatic anterior shoulder instability. If there is a bipolar lesion, that is, loss of glenoid bone plus a bony defect in the humeral head, then a glenoid lesion of between 10% to 20% may require a bony procedure. Outcomes of the latarjet procedure compared with bankart repair. Treatment of shoulder instability due to glenoid bone loss can be challenging. Rather, the latarjet procedure is preferred for those patients who have worn away at least 25% of the shoulder socket. The physician reserves the right to either advance or delay this protocol as. In the latarjet procedure, an incision is made over the front part of your shoulder and the coracoid bone is exposed.
The procedure was first described by french surgeon dr. Latarjet surgery for preventing shoulder dislocation. The modern version of the original technique prevents further episodes of dislocation in 9899% of patients and has a very low complication rate. Coracoid transfer as described by latarjet is a highly successful primary operation for recurrent anterior shoulder instability. Arthroscopic anterior stabilisation latarjet shoulderdoc. Latarjet shoulder surgery medical billing and coding. Recent reports have shown success with the latarjet procedure, as indicated by patient satisfaction scores and a low rate of recurrent instability. Latarjet procedure bristowlatarjet, coracoid transfer, or mod ified bristow with. The open latarjet procedure is more reliable in terms of shoulder stability.
Miguel ramirez is a fellowshiptrained shoulder surgeon with special training in complex shoulder reconstruction including the latarjet procedure. First described by a french surgeon hence the name. The shoulder joint is a ball and socket joint that connects the. Latarjet coracoid process transfer phase i weeks 04 protection sling to be worn at all times except for showering and rehab under guidance of pt range of motion true passive range of motion only to patient tolerance. It has the advantages of improving both the bony and soft tissue problems, with a strong fixation, allowing early active rehabilitation. The arthroscopic latarjet procedure is an evolving treatment for anterior shoulder instability in patients with significant glenoid bone loss, or failed softtissue repair. Latarjet shoulder stabilisation surgery is performed under general anaesthetic as day surgery, meaning you will usually be operated on and released on the same day, but sometimes you may have to stay in overnight depending how you are doing. The modern version of the original technique prevents. Initiate manual resistance er supine in scapular plane light resistance. Recurrent dislocation, with bony defect of anterior glenoid first time posting this procedure. Matthew provencher has described an alternative that uses fresh distal tibia allograft dta. The latarjet is a very effective and robust method to prevent further shoulder dislocations. In the latarjet procedure, an incision is made over.
The latarjet operation, also known as the latarjet bristow procedure, is a surgical procedure used to treat recurrent shoulder dislocations, typically caused by bone loss or a fracture of the glenoid. The latarjet procedure is an operation to stabilise the shoulder of an anterior dislocator when there is significant bony damage. Pdf modified latarjet procedure for patients with glenoid. The latarjet operation, also known as the latarjetbristow procedure, is a surgical procedure used to treat recurrent shoulder dislocations, typically caused by bone loss or a fracture of the glenoid.
Latarjet procedure gilbert, chandler, mesa az ospi. Bankart procedure augmented by coracoid transfer for contact athletes with traumatic anterior shoulder instability. The purpose of this study was to verify the hypothesis that this procedure is also effective for treating recurrent glenohumeral instability after previous operative repair. The shoulder joint provides a wide range of movement to the upper extremity but overuse or trauma can cause instability to the joint. There are a few modifications of the original techniques described by latarjet. The latarjet procedure is a surgical procedure performed to treat shoulder instability by relocating a piece of. Latarjet procedure is a reconstruction method to treat shoulder anterior instability. Devinder completed his medical qualifications from the university of melbourne and is a fellow of the royal australasian college of surgeons and the australian orthopaedic association. Latarjetbristow procedures shoulder symptoms, treatment.
Latarjet ultra finalword liverpool shoulder clinic. Postoperative protocols this rehabilitation protocol has been developed for the patient following an open bankart latarjet coracoid transfer surgical procedure. Latarjet shoulder stabilisation surgery circle health. The bony prominence at the front of the shoulder coracoid is. The initial phases of rehabilitation are needed to protect the shoulder sufficiently to allow for full bone healing. No active movement of shoulder till adequate prom with good mechanics no lifting with affected upper extremity no excessive external rotation rom stretching do not perform activities or strengthening exercises that place an excessive load on the anterior capsule of the shoulder joint i. In this case you may be a candidate for shoulder latarjet procedure in peoria, il.
The latarjet procedure is one of the most used surgical methods to treat recurrent anterior instability in the shoulder. The pdf of the article you requested follows this cover page. Feb 04, 2015 the latarjet procedure is an operation performed either arthroscopically or open for recurrent anterior shoulder instability, in the setting of glenoid bone loss. Dislocating your shoulder is painful and can lead to other serious issues as well. Aug 29, 2017 coracoid transfer, particularly the latarjet procedure, has become the treatment of choice for recurrent anterior glenohumeral instability in the setting of osseous deficiencies greater than 15%. The surgery involves taking a bone section from the coracoid process in the shoulder assembly with its muscles and grafting it to the glenoid, the front part of the shoulder joint socket, using two screws. Latarjet protocol the intent of this protocol is to provide the clinician with a guideline of the postoperative rehabilitation course of a patient that has undergone a latarjet procedure for anterior. Aspetar sports medicine journal open latarjet procedure for. The latarjet procedure is an operation performed either arthroscopically or open for recurrent anterior shoulder instability, in the setting of glenoid bone loss.
Arthroscopic latarjet is a difficult procedure that requires an advanced knowledge and experience on arthroscopic shoulder surgery due to the dangerous extraarticular area of the anterior shoulder, mainly because of the plexus location. The latarjet procedure involves transfer of the distal coracoid to the anterior inferior aspect of the glenoid. This is an enhanced pdf from the journal of bone and joint surgery j bone joint surg am. Arthroscopic latarjet procedure shoulder pain exercise. It can also be used as a salvage procedure in revision cases. This operation is becoming more popular in rugby and footy athletes, with afl stars such as nat fyfe, gary ablett and west coast ruckman. The latarjet procedure for the treatment of recurrence of. This procedure is done for recurrent shoulder instability where the instability is associated with bone loss at the front of the glenoid socket. This procedure is very effective at reducing recurrent dislocations, although it is a more complex surgery that requires longer rehabilitation and may result in a. Ice and modalities to reduce pain and inflammation. Continue to avoid heavy weight lifting or manual labor. Latarjet procedure for shoulder instability orthobethesda. First invented in 1954 by french surgeon dr michel latarjet, the advanced versions help achieve above 98% success rate. Open latarjet for anterior stabilization clinical practice guideline background ohio states latarjet anterior shoulder stabilization rehabilitation guideline is to be utilized following open anterior shoulder stabilization procedures.
The latarjet procedure is a surgical procedure performed to treat shoulder instability by relocating a piece of bone with an attached tendon to the shoulder joint. Pdf arthroscopic latarjet stabilization of the shoulder. This retrospective study was done with patients of a senior surgeon from. This article describes a modified, open latarjet procedure using a subscapularis splitting technique that. Shoulder latarjet coracoid transfer rehab protocol. Bristowlatarjet procedure for anterior shoulder instability. Below is a link to a description of the procedure from uk an excellent web resource for all things shoulder. However, the situation can arise when the need for a latarjet procedure becomes apparent only on initial arthroscopic inspection. Do not perform scaption with internal rotation empty can during any stage of rehabilitation due to the possibility of impingement. The bony prominence at the front of the shoulder coracoid is transferred to the front of the socket. Sep 26, 2017 this surgical procedure is used to improve recurrent shoulder dislocations. Latarjet coracoid process transfer phase i weeks 04 protection. Bristow latarjet procedure rehabilitation protocol this is similar to the bankart repair, but for added stability the tip of the coracoid process is transferred to the anterior rim of the glenoid fossa and fixed with a screw limiting er. Frequent cryotherapy for pain and inflammation premodulated electrical stimulation to shoulder for pain reduction patient education regarding posture, joint protection, positioning, hygiene, etc.
I need to make sure i am billing the right cpt for this shoulder surgery. Glorion anterior instability of the shoulder longterm results of. Postoperative rehabilitation is essential after latarjet anterior shoulder stabilization. For this reason it is necessary to consent patients accordingly.
Latarjet operation for shoulder reconstruction allan young. The procedure was first described by latarjet in 195422 when he published his technique of transferring the horizontal part of the coracoid to. Immediately postoperatively, exercises must be modified so as not to place unnecessary stress on the anterior joint capsule of the shoulder. It was first described by a french surgeon, michel latarjet, in 1954. Complications of the latarjet procedure request pdf. Latarjet anterior stabilization of the shoulder protocol latissimus dorsi tendon transfer protocol open shoulder anterior stabilization posterior and posterior inferior capsular shift protocol rehabilitation after rotator cuff repair.
These progressions are dictated by indication that the patient is pain free with activities of daily living, can tolerate late stage rehabilitation loaded exercises without pain and have full range of noncompromised shoulder movement. During the procedure the anterior coracoid is harvested and attached. Charles eggert, md postoperative protocol phase i maximum protection week 0 to 6 goals. Arthroscopic bankart repair and open latarjet bone block procedure are widely. This surgical procedure is used to improve recurrent shoulder dislocations. Despite excellent clinical results, the complication rates are reported between 15 and 30 %.
Begin shoulder prom do not force any painful motion. The intent of this protocol is to provide the clinician with a guideline of the postoperative rehabilitation course of a patient that has undergone a latarjet procedure for anterior stabilization. Aspetar sports medicine journal open latarjet procedure. The arthroscopic latarjet procedure is considered in the following situations. Ohio states latarjet anterior shoulder stabilization rehabilitation guideline is to be utilized. Keywords shoulder, open latarjet, anterior instability, bony defect.
Sling for 3 weeks athletes can wean off sooner under guidance of club therapist teach axillary hygiene. We use a congruent arc technique developed by joe debeer, which increases the joint surface contact area, enhancing the joint stability. It is used in patients with significant bony deficiency following shoulder dislocation, those with recurrent instability following traumatic dislocation or those who. Rehabilitation after the procedure is a slow progression over 4 to 6 months to regain range of motion and strength, while protecting the bony augmentation. The arthroscopic latarjet procedure is the same procedure but performed through keyhole incisions using very specialised instruments.
Latarjet repair rehabilitation protocol modalitieseducation. About 2cm of the bone is cut and moved to the front part of the shoulder in order to make a new shoulder socket. Latarjet reconstruction of glenohumeral joint cpt 23462 post op dx. Open bristow latarjet postop protocols 20191021t15. Manual prom, aarom, arom to restore normal rom per guidelines. Different to the open surgery, the arthroscope gives a. The amount of bone loss is best determined on a 3d ct the principle of a latarjet procedure is to cut and move the coracoid bone with the. I spent this morning in theatre, at london bridge hospital, with mr andy richards, consultant orthopaedic surgeon, observing what is commonly known as a latarjet procedure.
Yoneda m, hayashida k, wakitani s, nakagawa s, fukushima s. Common reconstructive techniques include the latarjet procedure coracoid transfer or glenoid augmentation using autograft iliac crest. It is used in patients with significant bony deficiency following shoulder dislocation, those with recurrent instability following traumatic dislocation or those who have failed soft tissue procedures e. Rehabilitation following latarjet surgery lasts for at least 46 months.
Latarjet procedure cincinnati shoulder instability. The latarjet procedure for recurrent anterior shoulder instability. Latarjetbristow procedure for recurrent instability. Devinder garewal is an orthopaedic shoulder specialist. Rehabilitation guidelines for open latarjet anterior shoulder.