If your shoulder has come out of the socket more than once, surgery has probably already come up as an option. What is less often explained is that not all instability repairs are the same, and the reason has to do with bone. The arthroscopic Latarjet procedure is one of the options considered when the front rim of the shoulder socket has worn down enough that a soft tissue repair alone may not hold.
What the Arthroscopic Latarjet Procedure Does
The shoulder is a shallow ball and socket. The socket, called the glenoid, is small relative to the humeral head, so stability depends heavily on the labrum, the capsule, and the muscles around the joint.
A Latarjet takes the coracoid, a small hook of bone on the front of the shoulder blade, and moves it to the front rim of the socket, where it is fixed with screws. Three things happen at once. The transferred bone widens the socket and restores the surface the humeral head sits against. The conjoint tendon, which stays attached to the coracoid, creates a sling across the front of the joint that tightens when the arm is raised and rotated outward. The capsule is then repaired over the top.
In the arthroscopic version, the surgeon works through small portals with a camera rather than through a single open incision. The steps and the goal are the same. The difference is the approach.
Why Bone Loss Changes the Surgical Decision
Every dislocation can shave a little bone off the front of the socket and can dent the back of the humeral head, a divot known as a Hill-Sachs lesion. After several episodes, the socket can lose enough of its rim that it no longer contains the ball well, no matter how carefully the soft tissue is repaired.
The Glenoid Track
Surgeons assess this using a concept called the glenoid track. Imaging shows how much of the socket rim remains and whether the divot on the humeral head stays within the contact zone through a normal arc of motion. If it slips off that zone, described as an off-track lesion, the shoulder can dislocate even with an intact soft tissue repair. That finding, along with the amount of bone missing, is a major factor in which operation is recommended.
Who Is Typically Considered for a Latarjet
Our surgeons at Skyline Orthopedics generally weigh this procedure for patients with recurrent anterior dislocations who also have meaningful glenoid bone loss, with a threshold around 20 percent of the socket width commonly cited in the literature. It is also considered after a soft tissue repair has already failed, in shoulders with an off-track Hill-Sachs lesion, and in some high-risk patients such as young collision athletes.
None of that is a checklist you can apply to yourself. Bone loss is measured on CT or specialized MRI, not estimated from symptoms, and two people with the same number of dislocations can need different operations. An evaluation is what establishes whether this applies.
How the Arthroscopic Version Differs From the Open Approach
The open Latarjet, performed through an incision at the front of the shoulder, has the longer track record and is what most published results describe. The arthroscopic version was developed later and lets the surgeon inspect and address other structures inside the joint at the same time through small portals.
It is also technically demanding, and it is performed by a smaller number of surgeons. Neither approach is better as a general rule. Which one is used depends on the anatomy, the surgeon’s training and experience with the technique, and what else the shoulder needs. Our orthopedic surgeons at Skyline Orthopedics who evaluate shoulder instability in Orland Park can explain which approaches apply to your situation and where you would be referred if a technique falls outside the practice.
Outcomes for Patients With Recurrent Dislocations
The reason this operation has stayed in use since the 1950s is that it addresses bone loss directly. Repeat dislocation after a Latarjet is uncommon in published series, generally reported in the single digits, with most patients regaining shoulder function and many returning to demanding activity, across studies with follow-up periods stretching to more than a decade.
Those figures describe groups of patients, not a prediction for any individual. Results depend on the amount of bone loss, whether the graft heals in position, the sport or job involved, and how rehabilitation goes. Some patients also develop shoulder arthritis over the long term after instability surgery, which is part of the conversation when the patient is young.
Recovery and Rehabilitation
Timelines here belong to your surgeon, because they depend on graft fixation, what else was repaired, and how the shoulder responds. The general shape of it looks like this.
Early Weeks
A sling protects the repair, usually for several weeks. The focus is pain control, swelling management, and protected motion. Overhead reaching and outward rotation are typically limited, because those are the positions that stress the graft while it is healing to bone.
Regaining Motion and Strength
Motion is restored gradually as the graft consolidates, followed by strengthening for the rotator cuff and the muscles that control the shoulder blade. Imaging is sometimes used along the way to check that the bone block has healed in position.
Returning to Sport and Work
Contact sport and heavy overhead work come last, often several months out, and clearance is based on healing, strength, and control rather than the calendar. Desk work generally resumes far earlier. Ask for your own restrictions rather than working from a general schedule.
Risks and Benefits Compared With Soft Tissue Repair
This is the real decision for most patients, and it is a trade-off rather than a ranking.
Where a Bankart Repair Usually Fits
An arthroscopic Bankart repair reattaches the torn labrum and tightens the capsule. It does not move bone, involves no hardware, and is a smaller operation with a narrower complication profile. In shoulders with little or no bone loss, it is a well-established option. Its weakness is that when a significant amount of the socket rim is gone, repairing soft tissue to a deficient rim leaves a higher chance of the shoulder dislocating again.
Where a Latarjet Is Considered Instead
The Latarjet rebuilds the missing bone and adds the tendon sling, which is why it is used when bone loss is the main problem. That comes with a broader set of risks. Reported complications include graft resorption or failure to heal, screw irritation or malposition, injury to nearby nerves, infection, stiffness, and the possibility of further surgery. Revision after a Latarjet is also more complex than revision after a soft tissue repair.
Put simply, a soft tissue repair is the smaller operation with more recurrence risk in the wrong shoulder, and a Latarjet is the larger operation that addresses bone loss but carries more that can go wrong. Matching the operation to the anatomy is the whole point of the workup.
Frequently Asked Questions
Finding Out Whether a Latarjet Applies to Your Shoulder
The question of which instability operation fits is answered by imaging and an exam, not by reading about the procedures. What is worth taking from this is that repeated dislocations are not only a soft tissue problem, that bone loss changes the answer, and that each episode can make the shoulder harder to fix.
If your shoulder has dislocated more than once, or if it feels like it is on the verge of giving way, you can schedule an evaluation with our orthopedic team.
This article is general education and is not medical advice. It is not a substitute for an examination, diagnosis, or treatment plan from a qualified physician.
Written by Dr. Jacob Stelter, MD, FACEP
Dr. Jacob Stelter is a board-certified physician specializing in sports medicine and non-operative orthopedics, treating a wide range of orthopedic and sports-related injuries including concussions, joint injuries, fractures, overuse injuries, and arthritis. He attended Loyola University Chicago Stritch School of Medicine, completed his residency in emergency medicine at Northwestern University, and finished a sports medicine fellowship at the University of Cincinnati. His approach focuses on holistic patient care, combining medical therapies, diagnostic testing, lifestyle and nutrition modifications, and counseling.
