There are a number of arthroscopic procedures that are performed to treat chronic shoulder instability. The patient’s age and sporting activities are considered before surgery is planned. The most common instability is an anterior (to the front of the joint) instability. Arthroscopic Bankart Repair, where the cartilage and soft tissue is reattached to the front part of the socket, is a common procedure. People participating in contact sport, especially rugby players, might require a bone and tendon restraint in the front of the joint. This is called a Latarjet procedure. Multidirectional and posterior (back of the joint) instabilities are relative rare and although non- operative treatment will usually suffice, surgery might be needed occasionally.
A Latarjet procedure is performed on the shoulder when there is a loss of bone of the socket caused by repeated dislocations. Large bone indentations called Hill Sachs lesions at the back of the humeral head may also be present and warrant a Latarjet procedure. The procedure is not performed arthroscopically and is performed through open surgery. During the procedure, I will remove a small piece of bone from part of the shoulder called the coracoid process and place it into the area of the shoulder socket where the bone has been worn away. This piece of bone is attached to the shoulder socket with the use of metal screws. The bone graft acts as a barrier, which works to prevent the shoulder from slipping out of its socket.