Latarjet with Coracoid Transfer

The Latarjet procedure with coracoid transfer is a specialized shoulder stabilization surgery used to treat recurrent shoulder dislocations and severe shoulder instability. It is most commonly performed when the shoulder repeatedly dislocates forward, known as anterior shoulder instability.

Unlike soft tissue repairs that focus mainly on torn ligaments or the labrum, the Latarjet procedure restores stability by transferring a small piece of bone from the shoulder blade, called the coracoid process, to the front of the shoulder socket. This transferred bone helps rebuild the damaged or worn portion of the socket while also creating additional support from the attached tendons.

The procedure is considered one of the most reliable surgeries for patients with significant bone loss, failed previous shoulder stabilization surgery, contact athletes, or individuals with severe instability that places them at high risk for repeated dislocations.

The Latarjet procedure primarily treats recurrent anterior shoulder instability. Many patients experience repeated shoulder dislocations after an initial traumatic injury, especially during sports, falls, or high-impact activities. The procedure is often recommended when instability becomes chronic or imaging shows bone damage to the shoulder socket.

Conditions commonly treated with the Latarjet procedure include:

• Recurrent shoulder dislocations
• Chronic anterior shoulder instability
• Bone loss of the glenoid socket
• Failed prior Bankart repair or labral repair
• Large Hill-Sachs lesions that contribute to instability
• Instability in contact athletes
• Shoulder instability associated with ligament laxity

Athletes involved in football, wrestling, rugby, martial arts, hockey, and other collision sports are particularly prone to recurrent instability after an initial dislocation. Younger patients also have a higher risk of repeated instability episodes.

The Latarjet procedure is often chosen for patients with substantial bone loss because standard labral repairs alone may not provide enough stability. It is also commonly used after failed previous stabilization procedures.

The Latarjet procedure is usually performed under general anesthesia. Many patients go home the same day, although some may stay overnight depending on the surgery’s complexity and their immediate recovery.

The surgery may be performed through a traditional open approach or arthroscopically using minimally invasive techniques with a small camera and specialized instruments. Both approaches aim to restore shoulder stability.

The procedure begins by accessing the front of the shoulder. Dr. Waterman identifies the coracoid process, a small, hook-shaped piece of bone near the front of the shoulder blade. A portion of this bone is carefully detached while preserving the attached tendons.

The front of the shoulder socket, called the glenoid, is then prepared. If bone loss or damage is present, Dr. Waterman reshapes the area so the transferred bone graft fits securely.

Dr. Waterman moves the coracoid bone graft to the front edge of the socket and fixes it in place with surgical screws. This transferred bone increases the socket’s size and depth, making it harder for the shoulder to dislocate again.

The attached tendons also play an important role. When the arm moves into positions that normally place the shoulder at risk, these tendons act like a dynamic sling that helps stabilize the joint.

If additional injuries are present, we may also treat them during surgery. Some patients have labral tears, capsule stretching, cartilage injuries, or rotator cuff damage that can be repaired at the same time.

The procedure typically takes one to two hours depending on the severity of instability and whether additional repairs are needed.

The Latarjet procedure has a high success rate for restoring shoulder stability and reducing the risk of future dislocations. Many patients regain confidence in their shoulder and can return to sports, exercise, and daily activities with improved stability and function.