Shoulder Dislocation – Instability

A 32 year old gentleman presented with several years of shoulder instability symptoms. He had the other shoulder reconstructed some years ago and was doing well. The recurrent instability symptoms led to him being not able to trust his shoulder overhead. He also complained of pain at rest and was unable to sleep on the affected shoulder.

A CT scan with 3D reconstructions demonstrated a bony bankart (bone fragment at the front of the socket) with glenoid bone loss (long term bone erosion at the front of the socket). The MRI interestingly revealed a posterior labral tear.

Given his inability to work overhead and be active – he elected to proceed with surgery.

The surgery commenced with arthroscopy of the shoulder and repair of the posterior labral tear with three anchors. Once the posterior labrum was repaired an open approach was used over the front of the shoulder to complete the latarjet procedure, with the graft secured using two screws.

Post-operatively he was placed in an external rotation sling and underwent JPL rehabilitation starting at two weeks. By three months he had closed to full range of motion and a CT scan at 6 months confirmed the coracoid graft had healed and he commenced all activities including contact sport.

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