Latarjet Procedure in Sydney

What is the Latarjet procedure?

The open Latarjet procedure is an operation used to treat recurrent anterior shoulder instability. Anterior instability means the ball of the shoulder repeatedly moves partly or completely out of the socket towards the front.

During the operation, the surgeon transfers a small section of bone called the coracoid process from the front of the shoulder blade to the lower front of the shoulder socket, known as the glenoid. The transferred bone is secured to the glenoid, commonly using two screws, so it can heal in its new position.

The procedure does more than simply add bone. The tendons attached to the coracoid are transferred with it and create a dynamic sling in front of the shoulder when the arm is raised and rotated. The operation may also include repair of the shoulder capsule. Together, these effects provide what is sometimes described as a triple stabilising mechanism:

• The transferred bone increases the effective width of the shoulder socket.
• The attached conjoint tendon creates a sling effect in front of the joint.
• The repaired capsule adds further soft-tissue stability.

A Latarjet procedure is generally considered when an arthroscopic labral repair alone may not provide enough stability. This is more likely when there is significant bone loss from the front of the glenoid, an engaging or off-track Hill-Sachs lesion on the humeral head, previous stabilisation surgery has failed, or the patient has a particularly high risk of recurrence.

Young patients involved in collision, contact or demanding overhead sport may also be considered for a Latarjet procedure where their injury pattern, bone loss and sporting goals make recurrent instability more likely.

Do you need a Latarjet procedure?

A Latarjet procedure is not required after every shoulder dislocation. Many first-time dislocations and some recurrent instability problems can be managed with rehabilitation or a less invasive stabilisation procedure.

The decision becomes more complex when the shoulder has dislocated repeatedly. Each episode can cause further injury to the labrum, capsule, glenoid and humeral head. Over time, this can reduce the amount of bone supporting the joint and make another dislocation more likely.

You may be considered for a Latarjet procedure if you have:

• Repeated anterior shoulder dislocations or subluxations
• Ongoing apprehension or a feeling that the shoulder may slip out
• Anterior glenoid bone loss that makes a soft-tissue repair less reliable
• A significant Hill-Sachs lesion on the humeral head
• A combination of glenoid and humeral head bone loss
• Failure of a previous arthroscopic Bankart or labral repair
• A bony Bankart injury that cannot be repaired reliably in its original position
• A high-risk sporting profile, particularly collision or contact sport
• Symptoms that continue despite appropriate non-operative rehabilitation

Your surgeon will usually assess your shoulder using a combination of your history, examination and imaging. X-rays can show alignment and larger bone injuries. MRI can assess the labrum, capsule, rotator cuff and associated soft-tissue damage. CT scanning is often used when accurate measurement of glenoid bone loss or evaluation of a Hill-Sachs lesion is required.

At your consultation, Dr Chan will assess whether the instability is traumatic, whether it is mainly anterior and whether the symptoms match the structural damage seen on imaging. A Latarjet procedure is not usually the right operation for multidirectional or primarily atraumatic instability without an appropriate structural indication.

Benefits and risks

What the procedure aims to achieve

• Reduce the risk of further anterior shoulder dislocation
• Restore stability when part of the front of the glenoid has been lost
• Provide stability where a soft-tissue repair alone may not be reliable
• Address recurrent instability after a failed previous stabilisation procedure
• Improve confidence when using the arm in overhead or vulnerable positions
• Support a return to demanding work, gym activity or sport after rehabilitation
• Protect the shoulder from repeated instability-related injury

Risks to understand

• Common and temporary: pain, bruising, swelling, weakness and reduced shoulder movement during the early recovery period
• Wound-related: infection, delayed wound healing, scar sensitivity or a visible scar at the front of the shoulder
• Bone-related: delayed union, non-union, graft fracture, graft resorption or healing in a suboptimal position
• Hardware-related: irritation, loosening, prominence or the need for later screw removal
• Joint-related: stiffness, loss of external rotation, ongoing pain or recurrent instability
• Structural injury: injury to nearby nerves, blood vessels, tendons, muscles, bone or cartilage
• Longer-term: development or progression of shoulder arthritis
• General: bleeding, blood clots, medication reactions and complications related to anaesthesia or existing medical conditions

The Latarjet procedure has a strong record of restoring stability in appropriately selected patients, including people with bone loss and those returning to demanding sport. It is, however, technically more involved than an arthroscopic soft-tissue repair and changes the anatomy at the front of the shoulder.

Accurate graft position is important. A graft positioned too far towards the joint may increase cartilage wear, while one positioned too far away may provide less effective stability. Your surgeon will discuss the balance between the expected benefit and the procedure-specific risks in your case.

Open Latarjet procedure	Arthroscopic Bankart repair
Transfers bone to the front of the glenoid	Repairs the torn labrum and tightens the capsule
Usually performed through an open incision	Performed through small keyhole incisions
Provides a bone-block and dynamic sling effect	Relies mainly on soft-tissue healing
Often considered when meaningful bone loss is present	Often considered when bone loss is limited
May be selected after a failed previous stabilisation	Commonly used as a primary stabilisation procedure
Frequently considered for high-risk contact or collision athletes	May suit lower-risk athletes with favourable anatomy
Requires the transferred bone to unite with the glenoid	Requires the labrum and capsule to heal to the glenoid

The choice is not based on whether one operation is universally better. It is based on matching the procedure to the pattern of damage and the risk of recurrence. In some circumstances, an arthroscopic Bankart repair with an additional remplissage procedure may also be considered.

The procedure: what happens

Preparing for surgery

The open Latarjet procedure is rarely an emergency operation. Where circumstances allow, preparation before surgery can improve your physical readiness, help you plan for the period in a sling and make the early recovery easier to manage.

At MTP Health, preparation may begin four to six weeks before surgery. Your physiotherapist or exercise physiologist can assess your shoulder function and provide an individual program focusing on:

• Rotator cuff strength and control
• Deltoid strength
• Shoulder blade or periscapular muscle control
• Movement in the neck, elbow, wrist and hand
• General fitness and lower-limb strength
• Practical strategies for managing everyday activities in a sling

Preparation also means planning the timing of surgery around work, study, family commitments, travel and important events. You will not be able to lift, drive or use the operated arm normally during the early recovery period, so arranging help at home can make a significant difference.

Your surgeon and anaesthetist need an accurate list of all medications, supplements and allergies. Medicines used for blood thinning, diabetes, blood pressure and inflammatory conditions may require specific instructions. Do not stop prescription medication unless your surgeon, anaesthetist or prescribing doctor has told you to do so.

Smoking and nicotine can impair wound and bone healing. Stopping as early as possible before surgery and remaining smoke-free during recovery is strongly recommended.

The skin around the shoulder, chest, armpit and upper arm should remain free from cuts, scratches, bites, rashes or infection. Avoid activities such as last-minute gardening or shaving the surgical area yourself. Contact the surgical team if you notice damaged or infected skin, as surgery may need to be delayed to reduce infection risk.

Hospital admission and fasting

The hospital will contact you before surgery to confirm your admission time and individual fasting instructions. Follow the instructions provided by your hospital and anaesthetist, even if they differ from general information you have read elsewhere.

As a general guide, solid food is usually stopped several hours before anaesthesia, while approved clear fluids may be permitted closer to the procedure. Clear fluids commonly include water and certain transparent drinks without milk or solid particles. Milk, cloudy juice and drinks containing pulp are not considered clear fluids.

Before the anaesthetic

You will usually arrive at hospital approximately one to two hours before the planned procedure. A nurse will complete admission checks and prepare the shoulder area. Hair may be clipped where necessary and the skin will be cleaned with an antiseptic solution.

You will meet the anaesthetic team, who will review your health, medications, previous anaesthetic experiences and pain-management plan. The procedure is performed under general anaesthesia. If appropriate and you agree, the anaesthetist may also perform a regional nerve block to provide additional pain relief after surgery.

Your surgeon will confirm the operation, shoulder and side with you and mark the surgical site. The theatre team then performs a formal safety check before the procedure begins, confirming your identity, consent, imaging, planned operation and correct side.

How the open Latarjet procedure is performed

You are positioned on the operating table with your head and upper body raised into a semi-reclined or beach-chair position. The arm, shoulder and surrounding skin are cleaned and draped under sterile conditions.

An incision is made at the front of the shoulder. The surgeon carefully works between the muscles to reach the coracoid process, a hook-shaped projection of the shoulder blade. The coracoid is prepared while preserving the attached conjoint tendon.

A measured section of the coracoid is cut from its base. Its undersurface is prepared to create a flat surface that can sit against the front of the glenoid. Drill holes are made in the graft in preparation for fixation.

The subscapularis muscle and tendon sit across the front of the shoulder. Rather than detaching the whole tendon, the muscle is commonly split in line with its fibres. This creates a pathway to the capsule and front of the glenoid.

The capsule is opened and the lower front of the glenoid is prepared. The coracoid graft and attached tendon are passed through the subscapularis split and positioned against the front of the glenoid.

The position of the graft is checked carefully before it is secured, most commonly using two screws. The goal is to restore the missing contour of the socket without leaving the graft too prominent within the joint.

The capsule is then repaired according to the surgical plan. The wound is washed and closed, usually with dissolvable sutures beneath the skin. An adhesive dressing is applied and your arm is supported in a sling, often with an abduction pillow.

The operation commonly takes approximately two to three hours, although this varies with the anatomy, previous surgery and complexity of the reconstruction. Additional time is needed for anaesthesia, positioning and recovery. Relatives should expect that several hours may pass between leaving the admission area and returning to the ward.

Immediately after surgery

You will wake in the recovery area, where nursing and anaesthetic staff monitor your breathing, circulation, pain and general condition. A regional nerve block can make the shoulder and arm feel numb, heavy or weak for several hours.

Once you are medically stable and comfortable, you will return to the ward. Your surgeon will usually contact your nominated relative or support person after the procedure, although this may be several hours after you entered the theatre area.

Your arm will remain supported in the sling. You will be encouraged to move your fingers and hand, and you may begin simple wrist or elbow exercises according to your post-operative instructions.

Some people are discharged the day after surgery. Others may require an additional night depending on pain control, medical needs, mobility, home support and the timing of the operation.

Dressings and wound care

Your adhesive dressing is water-resistant but should not be treated as completely waterproof. Keep the dressing clean, dry and intact until your first follow-up appointment unless the surgical team gives you different instructions.

A small amount of staining beneath the dressing can be normal. Contact the team if the dressing becomes saturated, the wound begins leaking persistently or you develop increasing redness, swelling, heat, fever or worsening pain.

Avoid soaking the wound in a bath, pool, spa or ocean until it is fully healed and your surgeon has confirmed that immersion is safe.

Cold and compression therapy

Cold therapy may help reduce pain and swelling during the early recovery period. If you have been supplied with a Game Ready unit, follow the program and duration recommended by your treatment team. Check the skin regularly and do not place ice directly against bare skin.

Cold therapy should support your recovery rather than replace your rehabilitation exercises or medication plan. If pain and swelling are well controlled, you may not need to use it as frequently.

Latarjet procedure recovery and rehabilitation

Recovery begins as soon as you wake from the anaesthetic, but the early priority is protection rather than aggressive shoulder exercise. The transferred coracoid needs time to unite with the glenoid, and the repaired tissues need time to heal.

Your rehabilitation program will be tailored to your operation, imaging, symptoms and progress. The exact timing of shoulder movement varies between surgeons and patients. Follow the protocol provided by your surgeon and rehabilitation team rather than progressing exercises independently.

Recovery timeline

Phase	Timeframe	What to expect
Protect the repair	Days 0–14	Sling protection, wound care, pain control and movement of the fingers, hand, wrist and elbow as instructed
Early healing	Weeks 2–6	Continued sling use, protection from lifting and gradual supervised shoulder movement where permitted by the surgeon
Restore movement	Weeks 6–12	Weaning from the sling, progressive range-of-motion work and restoration of everyday shoulder use without loading the graft excessively
Build strength	Months 3–4	Progressive rotator cuff, deltoid and shoulder blade strengthening once healing is satisfactory
Return to training	Months 4–6	Gradual return to gym, work conditioning, non-contact sport and sport-specific drills where strength and movement allow
Return to demanding activity	From approximately 6 months	Return to contact, collision or unrestricted overhead sport after clinical assessment, sufficient strength and evidence of graft healing

These timeframes are a guide only. The procedure performed, graft healing, previous surgery, symptoms, imaging findings and activity demands can all change the schedule.

The first six weeks

Your arm is generally protected in a sling during the first six weeks. The sling may only be removed for approved exercises, dressing, hygiene and clothing changes.

Depending on your surgeon's protocol, formal shoulder movement may be limited during this period. Some programs begin carefully controlled passive or assisted movement earlier, while others prioritise stricter protection. Do not compare your program with another patient's recovery.

You will usually be encouraged to perform circulation and mobility exercises for the fingers, hand and wrist. Elbow bending and straightening may also be permitted while the upper arm remains supported.

Do not lift, push, pull, support your body weight through the operated arm or reach suddenly away from your body. Even light household items can create more force at the shoulder than expected.

Sleeping and resting

Sleeping can be uncomfortable during the early recovery period. Many people find it easier to sleep in a reclined position or propped up with pillows. Sleeping flat on your back may become more comfortable as pain settles.

Avoid lying directly on the operated shoulder until your surgeon and physiotherapist confirm that it is safe and comfortable. Continue wearing the sling while sleeping for the prescribed period.

Showering and dressing

The sling can usually be removed briefly for hygiene, provided the arm remains protected and you follow the movement restrictions. Leaning slightly towards the operated side can allow access to the armpit without actively lifting the shoulder.

Some people use a separate sling for the shower. Loose-fitting, front-opening clothing is usually easier to manage than clothing that needs to be pulled over the head.

Weeks six to twelve

Once your surgeon is satisfied with the early healing, you may begin weaning from the sling and progressing shoulder movement. Rehabilitation focuses on restoring movement gradually without irritating the joint or placing excessive stress on the graft.

You should not force through sharp pain or aggressively stretch external rotation. The goal is steady improvement rather than recovering every degree of movement as quickly as possible.

Everyday use of the arm can increase during this phase, but heavy lifting, pushing, pulling and strengthening are generally still restricted until the graft has healed sufficiently.

From approximately twelve weeks

Progressive strengthening commonly begins at around three months, subject to clinical and imaging review. Early strengthening focuses on control and endurance before heavier resistance is introduced.

Your program may include:

• Rotator cuff strengthening
• Deltoid strengthening
• Scapular control and endurance
• Closed-chain shoulder exercises
• Gradual pushing and pulling patterns
• Work-specific lifting practice
• Overhead control
• Sport-specific preparation

Strength, movement and confidence continue improving beyond the point when the graft first unites. A minimum recovery period of around six months is common before unrestricted demanding activity, and some people require longer.

Rehabilitation at MTP Health

This is where MTP Health is different. Your rehabilitation can be delivered by physiotherapists and exercise physiologists working in the same clinical environment as your surgeon. Your program can begin before surgery and continue through the protective, movement, strengthening and return-to-performance stages.

Rehabilitation is not simply a list of shoulder exercises. It involves monitoring pain and movement, protecting the graft, rebuilding strength and preparing you for the specific physical demands of your life.

Your recovery may be supported by our pre-operative rehabilitation, post-operative rehabilitation, physiotherapy and exercise physiology services.

Returning to driving, work and sport

Driving

You should not drive while wearing the sling. Driving should also wait until you are no longer taking medication that affects alertness, judgement or reaction time.

Before returning to driving, you must be able to control the steering wheel, operate all controls, check blind spots and respond safely in an emergency. Your surgeon will advise when this is appropriate based on your side of surgery, movement, strength and recovery.

There is no single timeframe that applies to every patient or vehicle. Check with your surgeon and insurer before driving, particularly if you drive a manual vehicle, a heavy vehicle or drive professionally.

Office-based work

Computer-based or administrative work may be possible from approximately two weeks if pain is controlled, you are no longer taking strong pain medication and the workplace can accommodate the sling.

Some people need longer because commuting, prolonged sitting, sleep disruption or operating a mouse and keyboard increases discomfort. A staged return, shorter days or working from home may make the transition easier.

Physical work

Work involving lifting, pushing, pulling, climbing, reaching, overhead use or unpredictable loads requires substantially more recovery time. Meaningful lifting with the operated arm is generally restricted for approximately three months.

After that point, load needs to increase gradually. Returning to heavy manual work commonly requires a structured work-conditioning program and may take four to six months or longer.

Gym and general exercise

Walking and lower-body exercise may be resumed earlier if the shoulder remains protected and there is no risk of falling or loading the arm. Avoid running, cycling outdoors and crowded training environments while the arm is immobilised unless your surgeon approves them.

Shoulder resistance training commonly begins at around three months. Pressing, pulling, hanging, weight-bearing and overhead lifting are reintroduced progressively rather than all at once.

Non-contact sport

Non-contact training and sport-specific drills may begin from approximately three to four months where movement, strength and graft healing are satisfactory. The timing depends heavily on the sport.

Running may return earlier than swimming, racquet sport or overhead throwing because these activities place very different demands on the shoulder.

Contact, collision and overhead sport

Unrestricted contact or collision sport is commonly considered from around six months. Before clearance, you should have sufficient graft healing, functional shoulder movement, strength close to the opposite side and the confidence to tolerate contact or vulnerable arm positions.

Overhead athletes may require a longer sport-specific progression because throwing, serving, swimming and other repetitive overhead movements demand high levels of strength, speed and control.

Returning at six months should not be treated as automatic. Clearance is based on your examination, imaging, rehabilitation progress and the physical demands of your sport.

Follow-up after a Latarjet procedure

Your first post-operative appointment is usually held at approximately two weeks. This visit is important for checking the wound, reviewing pain and medication, confirming the rehabilitation plan and answering questions about the early recovery.

Further appointments may include:

• Approximately six weeks after surgery, often with an X-ray
• Approximately three months after surgery, with imaging where required to assess graft healing
• Approximately six months after surgery, particularly before returning to demanding work or sport

CT imaging may be used where a more detailed assessment of graft position and union is required. Your follow-up schedule will depend on your surgeon's protocol and how your recovery is progressing.

What outcomes can you expect?

The Latarjet procedure is a well-established treatment for recurrent anterior shoulder instability, particularly when bone loss is present. Most appropriately selected patients achieve a stable shoulder and many return to sport or demanding physical activity.

The operation cannot guarantee that the shoulder will never dislocate again. Recurrent instability can still occur, particularly after significant new trauma or when the graft does not heal or is not positioned optimally.

Some reduction in external rotation can occur, although the functional effect varies. Athletes who depend on extreme overhead movement may need additional time and sport-specific rehabilitation before returning to their previous level.

Shoulder arthritis can develop over the longer term. Repeated dislocations, cartilage injury, bone loss and the duration of instability before surgery all contribute to this risk. Graft position may also influence long-term joint wear.

The best outcomes generally come from selecting the right operation, positioning the graft accurately, protecting the repair during early healing and completing a structured rehabilitation program.

Latarjet procedure cost in Sydney

The cost of a Latarjet procedure depends on your private health cover, hospital policy, surgeon fee, anaesthetist fee, assistant fee, imaging, rehabilitation needs and any excess or co-payment attached to your insurance policy.

Before surgery, MTP Health provides written information about the surgeon's fee and informed financial consent. The anaesthetist and hospital are separate providers and may charge additional fees, so their costs should be confirmed directly.

Potential costs can include:

• Surgeon and surgical assistant fees
• Anaesthetist fees
• Hospital excess or co-payment
• Imaging and pathology
• Post-operative medication
• Sling, cold-compression therapy or other equipment
• Physiotherapy and exercise physiology

Health fund rebates and out-of-pocket costs vary considerably. Before committing to surgery, ask your surgeon, hospital, anaesthetist and health insurer for an itemised estimate based on your policy and planned procedure.

If surgery is provided through the public system, there may be no out-of-pocket surgical fee, but access, surgeon choice and waiting time depend on the hospital, urgency category and local availability.

Why have your Latarjet procedure at MTP Health?

MTP Health brings together upper-limb orthopaedic surgery, physiotherapy and exercise physiology within one clinical team. This matters because shoulder stabilisation is not only about performing the operation. It involves choosing the right procedure, preparing well, protecting the graft and progressing safely back to work or sport.

Honest advice comes first. If your shoulder is likely to improve without surgery, we will explain the non-operative options. If an arthroscopic stabilisation is more appropriate than a Latarjet procedure, we will explain why. If bone loss or another high-risk feature makes a Latarjet procedure the more reliable choice, you will be given a clear explanation of the expected benefit, recovery and risks.

Your rehabilitation can begin before surgery and continue afterwards with a team that understands the operation performed and the activities you need to return to.

Your surgeon

Frequently asked questions