Open Latarjet for Traumatic Shoulder Dislocation: A Technical Note

The Latarjet procedure is a common technique for treating symptomatic, recurrent anterior shoulder instability with significant glenoid bone loss and employs a standard subscapularis split to ensure optimal exposure and functional outcomes.

This procedure is indicated for primary or recurrent anterior instability, particularly in high-risk patients with approximately 15% anterior glenoid bone loss.

The patient is positioned in a beach-chair position, and sharp dissection is initiated at the superior aspect of the coracoid tip and extended inferiorly by 4 to 6 mm. The lateral border of the conjoint tendon is identified and released from the clavipectoral fascia. The coracoacromial (CA) ligament is identified and released from the coracoid using Bovie electrocautery, leaving a small segment for later capsular closure. The pectoralis minor is released from the medial coracoid border, exposing the coracoid base. After measuring the coracoid, an oscillating saw and osteotome are used to harvest the bone graft. The coracohumeral ligament is released, and the graft is prepared with a flat, bleeding surface to ensure optimal contact with the glenoid neck. Two drill holes are placed through the coracoid tip. Next, the subscapularis is split at the junction of the superior two-thirds and inferior one-third of the muscle belly, and the split is completed laterally. The plane between the subscapularis and capsule is developed. A horizontal split in the capsule is made to visualize the glenoid neck and anterior glenoid face. The anterior glenoid surface is cleared of capsule and decorticated. The graft is drilled using an offset guide, and cannulated screws are placed for fixation. A suture anchor is placed between the coracoid graft drill holes to secure fixation, while a suture is passed through the CA ligament stump and anteroinferior capsule, reinforcing the glenohumeral ligament complex and augmenting anterior stability.

Early outcomes of the standard Latarjet technique are favorable, including reduced recurrence of instability through glenoid augmentation and a conjoint tendon sling effect, with lower complication and reoperation rates and higher return to sport rates compared with other stabilization surgeries (eg, arthroscopic Bankart).

The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.

Surgeons should consider the Latarjet technique in indicated patients.