Latarjet Procedure

 

Aims:                    

To prevent recurrent anterior instability of the shoulder by transferring a bone block across the front edge of the glenoid.

 

Sling:                    

Night and day for first 3 weeks except for exercises, washing and dressing. 

Wean from sling from 5-6 weeks as pain allows.

 

Restrictions:          

Avoid abduction and external rotation (ABER) for first 8 weeks

 

0-3weeks:              

Check neuro vascular status and post op note

Hand, wrist and elbow active motion

Passive flexion of the shoulder up to 60 degrees in internal rotation

 

3-6 weeks:            

Gentle shoulder pendulum exercises

Shoulder shrugs

Elbow and hand exercises

External rotation to neutral only

Active assisted flexion up to 90 degrees

Active assisted abduction up to maximum of 60 degrees

 

6-9 weeks:             

Wean from sling

Commence active assisted flexion up to 90 degrees

Commence active assisted abduction up to 60 degrees

Aim for -passive/active assisted flexion to 75% of contralateral side by week 8

              -full active flexion by end week 9

              -50% of active external rotation by week 9

Isometric cuff strengthening in neutral

Scapular setting in neutral. Closed chain exercises in neutral

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9-15 weeks:           

Aim for 75% of active external rotation by week 15

Gently push active flexion, abduction and internal rotation

Check scapula setting and continue cuff strengthening

Proprioception exercises as control improves

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From 15 weeks:    

Aim for full range of movement. Don’t push external rotation too vigorously

Increase strengthening

 

Sports:                   

3 months-non contact sports (cycling, jogging, swimming- breast stroke)

4 months- return to contact

 

Work:                     

Sedentary jobs- as pain allows

Manual jobs- return 6-8 weeks and adjust for up to3 months

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Driving:                  

6-8weeks depending on review of bone block on X-rays