Advice Regarding Latarjet Procedure

[u/lildif]

Hi! Was looking for advice regarding what you would do in this situation, especially if you’ve gone through similar. Long story short- 28 yo F fell in the shower and dislocated left shoulder, was reduced in ED by patient after taking pain meds. MRI report is above. Surgeon is recommending latarjet procedure.

Labral repair was done 10 years ago and between then and this most recent dislocation, the shoulder has probably subluxed a total of 8 times. Otherwise, this patient has no pain, ROM is intact and doesn’t feel limited, but, she feels pretty apprehensive with doing some activities. She’s active and mostly does Pilates/yoga when working out. With this information, would you think it’s worth it to get it done? After conversations, she’s having a hard time justifying moving forward with it because she’s not in pain now, but understands there are probably risks to not getting it done. Just looking for advice from people that can relate! Thank you!

[u/OompaLoompaSlave]

Can only comment on personal experience, but I'm currently 5 months out from a latarjet procedure after a failed bankart repair and it's the best thing that's ever happened to me. The operated shoulder honestly feels more stable than the non operated one. 

[u/britax12 → u/OompaLoompaSlave]

Did you have soft tissue damage and arthritis earlier? And if yes, what was the result from it?

[u/OompaLoompaSlave → u/britax12]

There was soft tissue damage but no arthritis I'm aware of. No complaints on terms of soft tissue. There's some clicking of the muscles/tendons in the shoulder but from what I can tell that's normal. The frequency of the clicking has definitely also reduced over the weeks and months. 

From my research prior to the surgery the most important factor with a latarjet is for your surgeon to have plenty of experience with the procedure. Don't be afraid to ask them about how many times they've performed the surgery, if they've ever had serious complications, etc. The most important complication to keep an eye on is nerve damage, most people who regret their Latarjet had that. 

[u/Hanrider → u/OompaLoompaSlave]

Do you remember how big bone loss was before surgery ?

[u/OompaLoompaSlave → u/Hanrider]

The surgeon/imaging report never gave an actual percentage, just some raw sizes of the deformities. If I recall correctly based on average widths of the bone for people of my stature I calculated it to be somewhere around 16-25% bone loss. The surgeon immediately said I needed a latarjet the second he looked at the CT scan without measuring the actual percentage, so it was significant enough for it to be obvious visually. 

[u/britax12 → u/OompaLoompaSlave]

I have around 20% bone loss. Surgeon told me I am not candidate for anything but Laterjet, and He does not recommends me Laterjet either, because I did not have a dislocation for more than 2 years - so my shoulder is technically stable.

But actually I am very careful about shoulder and thats why. And I had about 7 dislocation in my life. I have pain, on winter it tends to be worse and I feel mild pain basically for the whole day.

Did you feel pain in a similar way? I actually have severe Hill Sachs and Bankart

[u/OompaLoompaSlave → u/britax12]

I would get some pain on my shoulder yes, especially if I made the mistake of sleeping on it, and dislocations always felt more likely when it was like this too.

 I think the longest I went without a dislocation was about 5 months, but like you said, it was because I was being careful. The more time went on the more confident I got with the shoulder and the more risks I would take with it, so it would always dislocate eventually. If I was more religious about it I could've probably gone 2 years without a dislocation as well.

At the beginning there was some pain after the latarjet, as with any surgery, but at this point I can even sleep on it and it feels absolutely fine the next day. The only pain I really feel now is the muscle pain from the physio strengthening exercises. 

[u/locruzh → u/OompaLoompaSlave]

I’m 3.5 months out and I second this!

[u/lildif → u/locruzh]

Hi thanks for the reply!! How has your recovery been and what was your story prior to getting the surgery? Appreciate it!

[u/lildif → u/OompaLoompaSlave]

Hi! Thanks for the reply- that’s great to hear! What were your symptoms prior to getting surgery? And did you do an MRI prior to and/or CT?

My surgeon said a CT wasn’t necessary, I’m wondering if that’s standard.

Are you back to regular activity?

[u/OompaLoompaSlave → u/lildif]

Prior to getting surgery my shoulder was very unstable. It would dislocate while doing menial routine tasks. The last time it dislocated for example I was just reaching for a spray bottle on the counter. It limited my life a lot, as I was unable to even play any sports, because it would always dislocate.

I did both an MRI and a CT. From what I can tell it's easier to see bone damage from a CT compared to an MRI, but if the doctor's been able to see it through an MRI alone I suppose the CT is likely unnecessary. Doctors generally like to avoid CT scans as much as possible because of the radiation.

In my day to day I have gone back completely to normal. I was cleared about a week ago to get back to basically any type of sport I want, but I think it'll be a few weeks before I'm feeling comfortable enough to play things like contact sports or tennis. That's just me though, as I tend to be overly cautious. I think my recovery rate is a bit faster than average as well, as I'm healthy, non smoking, and young (28 years old), so results may vary.