Latarjet Procedure in Sydney: The Rehab Pathway

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Latarjet Procedure in Sydney: The Rehab Pathway

If a surgeon has raised the Latarjet procedure with you, you're probably somewhere in the Sydney shoulder pipeline already — a few dislocations behind you, a CT scan showing bone loss, and a season you'd like back. This page covers what the operation involves, who it tends to be offered to, what you can do before the date, and how rehab is usually staged afterwards.

What the Latarjet involves

The surgeon takes the coracoid process, a small hook of bone at the front of the shoulder blade, with the conjoint tendon still attached, and fixes it to the front rim of the glenoid with screws or a button. That does three things at once. It replaces missing bone at the front of the socket. The transferred conjoint tendon passes across the front of the joint and adds a restraint when the arm is in the throwing position. The joint capsule is usually repaired over the top as well.

It can be done open or arthroscopically depending on the surgeon. Most people in Sydney have it as a day case or an overnight stay, with a sling afterwards.

Who it tends to be offered to

The Latarjet usually comes up in a few situations:

• Recurrent anterior dislocations with significant glenoid bone loss, often quoted around 15 to 20 per cent or more.
• A failed previous arthroscopic stabilisation, where the labrum has been repaired and the shoulder has dislocated again.
• Young contact and collision athletes with a high risk of recurrence — rugby, league, AFL, and sometimes judo or wrestling.
• Shoulders with a large engaging Hill-Sachs lesion on the humeral head.

Surgeons often use a scoring system such as the Instability Severity Index Score, which weighs age, sport, hyperlaxity and bone loss, to help decide between an arthroscopic Bankart repair and a bone block procedure. Ask which factors pushed the recommendation in your case. The answer is usually specific and worth understanding.

Prehab before the date

The weeks before surgery are useful, and often wasted. Shoulders that go into the operation with better range, better cuff strength and a trained scapula generally have less ground to make up afterwards.

Prehab commonly covers cuff and scapular strength within ranges that don't threaten the shoulder, grip and elbow work, and conditioning for the rest of the body so you're not starting from scratch on the bike in week three. It's also the time to rehearse the things you'll need immediately after surgery: dressing with a sling on, sleeping propped up, and getting in and out of a car with one arm.

Practical planning matters too. Sort out how you'll get to appointments, what your work can accommodate, and whether you drive. Most people are out of a car for several weeks, and that catches people off guard more than the surgery does.

How rehab is usually staged

Protocols differ between surgeons, so yours takes priority over anything written here. Broadly, the pathway looks like this.

Sling phase. Usually three to four weeks. Early work is elbow, wrist and hand movement, gentle passive and assisted range within the surgeon's limits, and keeping the neck and thoracic spine moving. External rotation is typically restricted early to protect the repair.

Range and early strength. From around week four to twelve, range is progressed toward full, and cuff loading starts light — isometrics first, then bands and light dumbbells. Many surgeons review imaging around the three month mark to check the bone block has united before heavier loading is cleared.

Strength building. From roughly three months, loading progresses into compound work, then into positions closer to the ones that provoked the original instability. Pressing, pulling, carries and gradually more range at end of external rotation.

Return to contact. For collision sport, this commonly sits somewhere in the six to nine month range, and is guided by the surgeon alongside objective strength testing, contact tolerance drills and match-speed training exposure. Timeframes vary with the individual, the sport and how the block has healed.

Testing rather than guessing

At the later stages, decisions are made on measurements rather than the calendar. That usually means handheld dynamometry for internal and external rotation strength with side-to-side comparison, endurance testing under repeated effort, upper limb load-bearing tests such as the closed kinetic chain upper extremity stability test, and progressive exposure to the actual demands of the sport — tackle bags before contact, contact before full match play.

For overhead workers, the equivalent is tolerance to sustained arm elevation and tool use, built up in stages rather than switched back on in one shift.

Questions worth asking your surgeon

Bring these to the pre-op appointment and write the answers down:

• Open or arthroscopic, and why for my shoulder?
• How long in the sling, and what range limits apply in the first six weeks?
• When do you want the first physiotherapy appointment?
• Will you image the graft, and when?
• What are your criteria for clearing contact or heavy overhead work?

Those answers shape the whole rehab programme, and having them in writing makes the handover between your surgeon and your physiotherapist far smoother.

The clinic is in Five Dock, convenient for Drummoyne, Concord, Haberfield and the rest of the Inner West, and works alongside Sydney shoulder surgeons through both prehab and post-operative rehab. If you have a Latarjet booked or are weighing it up, book an assessment and we'll map out what the next stage looks like.