Saturday, July 12, 2014

Case Study: Repeated Shoulder Dislocations and the Latarjet Procedure



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. 
Latarjet Procedure
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.



 


Monday, June 16, 2014

Advocare Orthopedic and Sports Medicine Goes to New Orleans



Orthopedic Surgeon, John Vitolo, MD recently attended the annual American Academy of Orthopedic Surgeons meeting (AAOS) in New Orleans, LA. The meeting is focused on continuing education and the latest advances in orthopedic surgery. Dr. Vitolo stated, “As a surgeon, extremely important to stay connected with peers and learn what others are doing. This meeting allows us to re-connect and continue the learning process. By sharing experiences, we can ensure that we are taking the best possible care of our patients.”

As part of the meeting, John Vitolo, MD was featured as a contributing writer to the AAOS sponsored website, anationinmotion.org. This website features prominent orthopedic surgeons, patient stories and articles about orthopedic surgery. Dr. Vitolo’s articles and profile are featured on the site.

Dr. Vitolo was excited to share with colleagues that the office recently implemented a system that follows up on surgical outcomes for 2 years post-surgery. Surgical Outcomes Systems (SOS) tracks patients at various intervals to see how the progress post-op. This system allows the office to see how patients are doing well beyond the required follow-up office visits.

In other recent news, for the second year in a row, John Vitolo sponsored the United Way’s scholar athlete program. Vernon’s Jinan Andrews, was awarded a $1,000 scholarship towards his college education. Dr. Vitolo says, “It is a great honor to sponsor these athletes and this program. Athletes work hard, and it is wonderful to be able to give them some help toward college tuition.”
John Vitolo, MD and Scholar Athlete Jinan Andrews

Advocare Orthopedic and Sports Medicine, the office of John Vitolo, MD, is located in Sparta, New Jersey. The practice focuses on treatment of the shoulder and knee, specifically sports and workplace injuries. For more information about the practice, please visit www.advocareorthosportsmed.com.