Recently, we had an interesting case with a young man in his
early 20’s. The patient had dislocated his shoulder “100 times” following a
previous surgery (anterior labral repair) performed by another physician. Shoulder
dislocation is not only painful, but debilitating. The patient stated that
any movement would cause the shoulder to dislocate – even in his sleep.
A CT Scan was performed to look at the structure of the
shoulder bones and revealed that the glenoid bone (the socket of the shoulder) was
missing (see pictures). The repeated dislocations likely caused the loss of the front
of the glenoid bone. If not repaired, the shoulder would continue to dislocate.
Normal Glenoid |
CT Scan of Missing Bone on Glenoid
|
In this case, we opted to
perform an open surgery known as the Latarjet Procedure. The Latarjet procedure
was first performed in France by a French surgeon, Michel Latarjet. The
procedure has excellent success rates in patients with recurrent dislocations
and recurrence of injury is low.
In the Latarjet procedure, a
portion of bone is taken from scapula (shoulder blade) called the corocoid. The
corocoid is a hook of bone located in the front of the shoulder blade. In the
Latarjet procedure the corocoid is removed from the scapula, with the muscles
still attached. The corocoid is then screwed into the shoulder socket where it
replaces the lost bone (see picture below). The attached muscles are then secured to offer support
in the front of the shoulder.
In this case, the surgery
was a great success. The patient was in a sling for 4 weeks following surgery
to protect the repair. He then performed physical therapy 3x/week for 16 weeks
and is no longer dislocating his shoulder. The patient is very happy with the
results.
Latarjet Repair - Bone restored to prevent dislocation |
John Vitolo, MD is a
board certified orthopedic surgeon specializing in injuries and conditions of
the shoulder and knee. With over 25 years of experience, Dr. Vitolo is an
expert in the field. To make an appointment, please call 973-300-1553 or visit
advocareorthosportsmed.com to learn more.
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