The latarjet procedure for recurrent anterior shoulder instability: Rationale and technique

The Latarjet coracoid transfer procedure provides a "triple blocking" effect in the treatment of anterior shoulder instability. First, the coracoid bone block increases the anterior posterior diameter of the inferior portion of the glenoid fossa, making it more difficult for the humeral head to subluxate or dislocate. Second, the conjoined tendon acts as a sling reinforcing the inferior capsular ligamentous complex and the inferior portion of the subscapularis. Finally, repair of the inferior capsular ligamentous complex to the stump of the coracoacromial ligament reconstructs the capsulolabral anatomy. We describe our preferred technique for this procedure. With proper patient selection and systematic surgical technique, instability can be eliminated without loss of external rotation in more than 98% of cases.