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Prosedura ng Latarjet

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Rehabilitation protocol after the Latarjet coracoid bone-block transfer for anterior shoulder instability — union-gated loading and subscapularis/graft precautions.

Isang guhit-kamay na ilustrasyon ng isang manlalaro ng rugby na nag-aayos ng kanyang balikat habang tinatamaan.
Rehabilitasyon pagkatapos ng Latarjet procedure. Kieran Hirpara 4.0

Ang pahinang ito ay isinalin ng makina at hindi pa nasusuri ng isang doktor. Ang bersyong Ingles ang siyang opisyal.

Ang protocol na ito ay gabay sa iyong paggaling pagkatapos ng Latarjet procedure kay Dr Kieran Hirpara sa Mater Private Hospital Rockhampton. Kasama nito ang paliwanag sa bawat yugto sa simpleng wikang Ingles at isang estrukturadong programa na maaari mong ibahagi sa iyong pisyoterapeuta; dalhin ang pahinang ito o ang PDF nito sa iyong unang appointment upang manatiling koordinado ang iyong rehabilitasyon. Maaaring baguhin ng iyong pisyoterapeuta ang plano depende sa pag-unlad ng iyong paggaling.

Kung mayroon kang anumang alalahanin tungkol sa iyong sugat pagkatapos ng operasyon, makipag-ugnayan sa opisina. Karaniwang makakatulong na kumuha ng litrato ng sugat at ipadala ito sa pamamagitan ng email para sa pagsusuri.

Ano ang inaasahan

Ang Latarjet ay isang bone-block na operasyon para sa balikat na paulit-ulit na lumilipad papunta sa harap. Dahil ito ay gumagamit ng matibay na buto na nakafix gamit ang mga turnilyo (imbes na kumpletong pagtahi lamang sa malambot na tisyu), ang pagkakaayos ay matibay sa maagang yugto, at ang iyong paggaling ay karaniwang mas mabilis kumpara sa pagkakaayos ng malambot na tisyu (isang Bankart repair). Sa average, bumabalik ang mga tao sa sports sa humigit-kumulang 20 linggo, kumpara sa humigit-kumulang 32 linggo pagkatapos ng isang Bankart.

Ngunit ang "mas mabilis" ay hindi nangangahulugang "mga ginagawa man lang ay okay." Ang bilis ng iyong paggaling ay nakadepende sa isang bagay lamang: ang paggaling ng naipasa na buto sa iyong shoulder socket. Ang pagkakakonekta ng buto na ito (tinatawag na union) ay karaniwang tumatagal ng humigit-kumulang 6 hanggang 8 linggo. Hangga't hindi pa nakumpirma ng iyong doktor na nakagaling na ito, pinipigilan ang paglalagay ng bigat sa balikat, anuman ang magandang pakiramdam ng braso. Ang Latarjet ay may dalawang karagdagang istruktura upang protektahan ang balikat na hindi mayroon ang Bankart, kaya ang ilang maagang pagbabawal sa ibaba ay partikular sa operasyong ito.

Ang prosedura

Sa isang Latarjet, isang maliit na piraso ng buto na tinatawag na coracoid (isang butong pagkabukod sa harap ng iyong scapula) ay ililipat at iiafixo gamit ang mga tornilyo sa harap na gilid ng iyong shoulder socket, kung saan nawala ang buto. Nagdaragdag ito ng buto kung saan ito ay kulang at lumilikha ng epekto ng "sling" sa harap ng balikat na tumutulong na pigilan itong lumabas sa posisyon.

Upang ilipat ang butong iyon sa tamang posisyon, kailangang dumaan ang surgeon sa subscapularis (isang kalamnan sa harap ng balikat), na hinahati, o bahagyang tinatanggal at pagkatapos ay aayusin. Kaya't dalawang bagay ang kailangang protektahan habang nagpapagaling:

  • ang bone block at ang mga tornilyo nito, na dapat mag-ugnay sa iyong socket (union, humigit-kumulang 6–8 linggo); at
  • ang kalamnan ng subscapularis sa harap, na aayusin sa paligid ng na-transferred na buto.

May ilang tao ang natitira na may maliit na permanenteng pagkawala ng saklaw ng outward-rotation (pag-ikot ng kamay palabas) na humigit-kumulang 7–8 degrees. Ito ay inaasahan at hindi komplikasyon; para sa karamihan, walang epekto ito sa pang-araw-araw na buhay.

Pagsuot ng iyong sling

Susuot ka ng simpleng shoulder sling, hindi abduction-pillow o wedge sling. Ginagamit ni Dr. Hirpara ang simpleng sling para sa stabilisation surgery, dahil matibay ang bone fixation at ang proteksyon ay pangunahing nanggagaling sa pagpapanatili ng braso sa ligtas na posisyon, hindi sa hugis ng sling.

  • Isusuot ang sling ng humigit-kumulang 2 linggo para sa suporta at kaginhawaan sa araw. Mas maikling oras ang kinakailangan ng bony Latarjet sa sling kumpara sa soft-tissue repair.
  • Hindi ka matutulog na may sling. Matulog nang walang sling; panatilihin ang iyong braso sa ligtas na posisyon habang natutulog: huwag hayaang mahulog ito sa gilid at nakabaluktot palabas (ang posisyon na pinoprotektahan ng operasyon). Ang pagtulog na may suporta sa braso gamit ang unan sa harap ng katawan o sa gilid ay komportable at ligtas.
  • Bawasan ito para sa pagliligo at sa iyong mga ehersisyo (pagkatapos ipakita kung paano). Kapag inalis ang sling, panatilihin ang iyong braso na nakarelaks at nasa gilid ng katawan.
  • Gumamit ng yelo kung pamamaga o masakit ang balikat, lalo na pagkatapos ng ehersisyo.

Bantayan ang iyong postura habang gumagamit ng sling: panatilihin ang tuwid na pagkakahanay ng mga tainga, balikat, at balakang, at iwasan ang pagkukurbado.

Mahalagang pag-iingat — huwag gawin

Ipinoprotektahan nito ang bone block, ang mga turnilyo nito, at ang harapang kalamnan habang nagpapagaling.

  • Huwag pilitin ang braso sa outward rotation (pag-ikot ng kamay palabas) sa maagang yugto. Sa unang 2 linggo, ang outward rotation ay pinapanatili sa humigit-kumulang 25 degrees sa isang suportadong posisyon, at dahan-dahang binubuksan lamang pagkatapos nito, palaging nasa loob ng saklaw na itinakda ng iyong surgeon.
  • Huwag itulak ang braso pabalik sa likod ng iyong katawan (shoulder extension), at iwasan ang pinagsamang posisyon ng braso na nakatuon palabas at nakahabang pabalik. Ito ay humihigpit sa tendon na nakadikit sa na-transfer na buto.
  • Huwag gumawa ng resisted inward-rotation na pagsasanay sa lakas sa maagang yugto (pagpindot ng kamay nang malakas papasok sa katawan laban sa resistensya). Ito ay gumagana sa nagpapagaling na harapang kalamnan (subscapularis) at pinipigilan hanggang sa magbigay ng pahintulot ang iyong surgeon.
  • Huwag magpatimbang ng bigat sa pamamagitan ng braso o kamay, itulak upang tumayo mula sa upuan gamit ang braso, o mag-angat, magtulak, o humila ng anumang mabigat hanggang sa kumpirmahin ng iyong surgeon na ang buto ay nag-union (humigit-kumulang 6–8 linggo). Ang bony join, hindi ang kalendaryo, ang nagdidikta kung kailan maaaring magsimula ang mas mabigat na paglo-load.
  • Huwag gumawa ng mabibigat na ehersisyo sa dibdib o sa itaas ng ulo sa gym sa maagang yugto: walang pec flys, wide-grip bench press, military (overhead) press, behind-the-neck lat pulldowns, o triceps dips hanggang sa huling bahagi ng iyong paggaling.
  • Iwasan ang anumang biglaang hatak, hawak, o pagbagsak sa braso.

Yugto I — Agad na proteksyon (linggo 0–2)

Ang unang dalawang linggo ay nakatuon sa pagprotekta sa bagong inilipat na bloke ng buto at sa naayos na harapang kalamnan habang bumababa ang pamamaga. Suot mo ang simpleng sling sa araw, matutulog nang walang sling (pinapanatiling nasa ligtas na posisyon ang braso), at gagawa ng magaan na ehersisyo na nagpapanatiling gumagalaw ang iyong kamay, pulso, at siko hindi nagpapabigat sa balikat. Ang balikat mismo ay galawin lamang nang dahan-dahan at pasibo; hindi mo pa ito itataas gamit ang sarili mong lakas ng balikat.

  • Sling: simpleng sling para sa suporta at kaginhawaan sa araw; matutulog WALANG sling na nasa ligtas na posisyon ang braso; alisin para sa mga ehersisyo at paglilinis.
  • Pinapayak na galaw: dahan-dahang tulong at pasibong galaw lamang; huwag itaas ang braso gamit ang sarili mong lakas ng balikat. Pasahing itaas at umabot sa gilid para sa kaginhawaan; panatilihin ang pag-ikot palabas sa humigit-kumulang 25 degrees sa isang suportadong posisyon; huwang itulak ang braso pabalik sa likod ng katawan.
  • Mga ehersisyo: pagtatakda ng balikat; pagpi-piga ng bola; dahan-dahang paggalaw ng kamay, pulso, at siko; pag-ikot ng pendulum (relaksado ang braso, hindi bumababa pabalik).

Handa na para sa susunod na yugto kapag: bumababa at kontrolado na ang iyong sakit gamit ang simplang gamot pang-alis ng sakit; gumaling na ang iyong sugat na walang senyales ng problema; komportable ka nang walang sling; at nananatili sa ligtas na saklaw na itinakda ng iyong doktor ang iyong dahan-dahang paggalaw.

Yugto II — Pagpapatibay ng galaw (linggo 3–9)

Ngayon, ang pokus ay nasa galaw, hindi sa lakas. Iniiwasan ang paggamit ng sling mula sa mga linggo 3. Dahan-dahang lumilipat mula sa tulong sa paggalaw patungo sa paggalaw ng braso gamit ang sarili mong lakas, at dahan-dahang binubuksan ang outward rotation; sa unang yugto hanggang humigit-kumulang 45 degrees sa isang suportadong posisyon, pagkatapos ay hanggang sa toleransya mula sa mga linggo 6, laging nasa loob ng mga limitasyon ng iyong doktor. Idinadagdag ang magaan na press-and-hold (isometric) na ehersisyo, pinapanatiling banayad ang pagsisikap sa inward rotation upang maprotektahan ang harapang kalamnan. Ang paglalagay ng bigat ay naghihintay pa; ang bone block ay nagsisimula lamang mag-ugat sa yugtong ito.

  • Sling: iniiwasan mula linggo 3.
  • Pinapayagang galaw: tulong sa paggalaw na lumalawak patungo sa paggalaw gamit ang sarili mong lakas sa mga linggo 6 (patungo sa humigit-kumulang 90–110° ng elevation). Dahan-dahang binubuksan ang outward rotation; sa unang yugto humigit-kumulang 45 degrees sa suporta, pagkatapos ay hanggang sa toleransya, nasa loob ng saklaw na itinakda ng iyong doktor. Banayad na inward rotation hanggang humigit-kumulang 45 degrees.
  • Mga ehersisyo: full-can lift hanggang taas ng balikat; banayad na pag-ikot palabas (outward-rotation) gamit ang band sa ibabaw ng towel roll; banayad na pag-ikot papasok (inward rotation) gamit ang stick (walang puwersa); low row; banayad na press-and-hold na isometric para sa outward rotation at abduction mula sa linggo 6 (ang inward-rotation isometric ay hahawakan pa nang bahagya hanggang sa mas huli). Maaari ding idagdag ng iyong pisioterapeuta ang banayad na rhythmic stabilisation (mga drill na humihinto at nananatiling matatag kung saan dahan-dahang tinutulak ng doktor ang iyong braso at ikaw ay lumalaban) upang muling ituro ang kontrol; ito ay mga gawaing kamay na walang diagram.

Handa na para sa susunod na yugto kapag: kumpirmado ng iyong doktor (karaniwan sa review sa mga linggo 6–8) na ang bone block ay nag-ugat na; kayang galawin mo ang braso gamit ang sarili mong lakas na may mahusay na kontrol; ang iyong tulong at pasibong paggalaw ay kumpleto o halos kumpleto at komportable; at walang pagtaas ng sakit pagkatapos ng banayad na isometric. Ang pagpapalakas ay hindi magsisimula hanggang kumpirmado ang pag-ugat: ito ay nakadepende sa paggaling ng buto, kumpirmado ng iyong doktor, hindi sa kalendaryo.

Yugto III — Pagpapalakas (linggo 10–15)

Kapag kumpirmado ng iyong doktor na nagkakaisa na ang buto, maaari nang simulan ang pagdadagdag ng bigat sa balikat. Ang pagpapalakas ay gumagamit ng magaan na mga rubber band at magaan na mga timbang sa simula: mataas na bilang ng paulit-ulit at mababang bigat, na unti-unting pinapalakas. Ang pangunahing alituntunin ay isang direksyon sa isang oras: ikaw ay nagpapalakas lamang sa isang direksyon kapag mayroon ka nang komportableng halos-kumpletong galaw dito. Ang pagpapalakas para sa panloob na pag-ikot at sa harap na kalamnan (subscapularis) ay ipinakilala pa rin nang maingat at nang huli, dahil ang kalamnang ito ay na-repair sa panahon ng iyong operasyon.

  • Sling: wala; inaasahan ang halos-kumpletong, komportablong galaw bago magdagdag ng bigat sa isang direksyon.
  • Mga ehersisyo: full-can lift na may magaan, lumalaking bigat; magaan na biceps curls; resistance-band rows; wall push-up-plus at supine forward punch para sa harap na kalamnan; panloob na pag-ikot sa likod gamit ang baston (banayad, mula sa mga linggo 12 kapag gumaling na ang harap na kalamnan). Unti-unting dagdagan ang bigat at huminto kung masakit o namamaga ang balikat.

Handa na para sa susunod na yugto kapag: mayroon kang kumpletong, walang sakit na galaw sa sarili mong kapangyarihan na may mahusay na kontrol sa balikat; walang sakit o pamamaga pagkatapos ng mga sesyon ng pagpapalakas; komportableng resistadong pag-angat sa ilalim ng taas ng balikat; at lumalakas ang iyong lakas sa panlabas na pag-ikot patungo sa kabilang panig.

Yugong IV — Sa itaas ng ulo at pagbabalik sa isports (linggo 16–20)

Ang yugong na ito ang tulay patungo sa is ganap na gumagana na balikat at is unti-unting pagbabalik sa isports at mas mabigat na trabaho. Pinapanatili mo ang saklaw ng galaw na nakuha mo at binubuo ang lakas, kapangyarihan, at tibay upang gamitin ito nang may kumpiyansa, kasama na ang mga galaw sa itaas ng ulo. Ang pagbabalik ay may mga yugong, hindi biglaan; para sa isports, ang isang programa na may interval na nagpapataas ng dami at intensity hakbang-hakbang ang pinakaligtas na paraan para bumalik.

  • Sling: wala.
  • Mga ehersisyo: overhead full-can lifts na may magaan, tumataas na bigat kapag ang lakas sa ilalim ng taas ng balikat ay maganda na; progressive band rows; kondisyon na espesipiko sa isports at trabaho, at sa huling bahagi ng yugong, kontroladong mas mabilis na (plyometric) drills kung angkop. Maaaring idagdag ang push-ups habang pinipigilan na ang mga siko ay hindi lumilipat nang malayo pabalik.

Handa na para bumalik kapag: ang lakas ng outward rotation ay nasa loob ng humigit-kumulang 8–10 degrees ng kabilang bahagi at ang kabuuang lakas ng rotation ay pantay-pantay na tumitibay; mayroon kang buo, walang sakit na paggalaw na walang reaktibong pamamaga sa ilalim ng mas mabigat na load; at nakapasa ka sa mga task-specific na pagsusuri para sa iyong isports o trabaho. Karaniwang nasa paligid ng 20 linggo ang pagbabalik sa isports, at ang mga isports na may contact o collision ay kadalasang medyo higit pa pa (paligid ng 5–6 buwan), batay sa pagtupad sa mga kriteryong ito at sa clearance ni Dr Hirpara at ng iyong physiotherapist, hindi lamang sa kalendaryo.

Pagbabalik sa isports at trabaho

Ang iyong pagbabalik ay batay sa mga kriteryo: walang sakit, may sapat na saklaw ng galaw, lakas, at tibay, at may pahintulot mula kay Dr. Hirpara at sa iyong pisyoterapeuta, hindi lamang nakadepende sa kalendaryo. Dahil ang Latarjet ay gumagamit ng matibay na buto, karaniwang mas mabilis ang paggaling kumpara sa pagkumpuni ng malambot na tisyu, ngunit ang lahat ng mas mabigat kaysa sa banayad na galaw ay inaantay hanggang sa magsama ang bloke ng buto (humigit-kumulang 6–8 linggo, kumpirmado ng iyong doktor).

  • Ang magaan na gawain sa antas ng dibdib ay maaaring muling gawin mula sa humigit-kumulang 10–15 linggo.
  • Ang mga gawaing nakatuon sa itaas ng ulo at paghahagis ay mula sa humigit-kumulang 4 buwan.
  • Ang pagbabalik sa isports ay humigit-kumulang 20 linggo sa average; ang buong kontak o sports na may banggaan ay karaniwang nasa 5–6 buwan, at laging pagkatapos matugunan ang mga kriteryo sa lakas at galaw.

Pagkatapos ng iyong protocol

Ang protocol na ito ay kasabay ng pangkalahatang payo para sa paggaling ng klinika; tingnan ang pamamahala ng sakit pagkatapos ng operasyon at pag-aalaga sa sugat.

Reviewed by Dr Kieran Hirpara · 17 June 2026.

Want the clinical detail? Read the clinician version.

Talk to your treating clinician for advice specific to you.

For an appointment with the CQ Hand + Upper Limb team, ask your GP about a referral or visit www.cqupperlimb.com.

Evidence & references

Latarjet (Coracoid Transfer) for Anterior Instability with Bone Loss: Rehabilitation Evidence

Topic: Open Latarjet / Bristow-Latarjet coracoid transfer for anterior glenohumeral instability with glenoid bone loss (>~20% glenoid, or off-track Hill-Sachs / failed soft-tissue repair). Compiled: 2026-06-16. Sources: local RAG Orthopaedic corpus + published fellowship/PT "standard of care" protocols.

How Latarjet rehab DIFFERS from arthroscopic Bankart

  • It is a BONY procedure (coracoid autograft screw-fixed to the antero-inferior glenoid). Fixation is rigid -> the structural construct is stronger than soft-tissue suture anchors, so AROM and return to sport are generally FASTER than Bankart (Beletsky 2020: mean RTS ~19.6 wk Latarjet vs ~32.4 wk Bankart, p<0.001).
  • BUT two distinct soft-tissue structures must be protected that Bankart does not involve: (1) the subscapularis (split, or taken down and repaired, to pass the graft); (2) the coracoid graft osseous union (~6-8 weeks to unite) plus the conjoint-tendon (biceps short head + coracobrachialis) "dynamic sling" still attached to the graft.
  • Graft-protection precautions: avoid aggressive shoulder extension and combined extension + external rotation stretching early (tensions the conjoint origin on the graft). Progress biceps/coracobrachialis strengthening gradually. If subscapularis was taken down & repaired, slow ER progression and avoid aggressive IR strengthening until subscap healed - get an intra-operative "safe-zone" ER from the surgeon.
  • Expect a permanent mild ER deficit (Hovelius: mean loss ~7.4 deg in adduction, ~8 deg in abduction) - this is accepted, not a complication.

Consensus phased timeline (BWH Latarjet standard of care)

Phase Week window Sling/brace ROM allowed & restrictions AROM / strengthening RTS
I - Immediate post-surgical 0-2 wk Sling at all times (remove only to shower, arm at side); towel under elbow to prevent hyperextension (graft protection); sleep in sling No AROM. PROM only, no forcing: flexion/elevation & scaption to tolerance; IR to 45 deg at 30 deg abd; ER 0-25 deg in scapular plane at 30-40 deg abd (open-packed); respect anterior capsule; use intra-op ER measurements Scapular isometrics, ball squeezes; cryotherapy None
II - Intermediate / ROM 3-9 wk Wean from sling beginning wk 3 Early (wk 3-4): ER to 0-45 deg at 30-40 deg abd, IR 45 deg at 30 deg abd. Late (wk 6): ER to tolerance, progress to multiple abd angles once >=35 deg; IR multi-angle. AAROM from wk 3 -> AROM by ~wk 6 (good mechanics, up to 90-110 deg elevation) Begin balanced AROM/strengthening late phase II (~wk 6): high-rep/low-load (1-3 lb), full-can scaption to 90 deg, ER/IR tubing at 0 deg abd (towel roll), prone rows, rhythmic stabilisation. Subscap-specific work (upper+lower fibres) None
III - Strengthening 10-15 wk None Continue A/PROM; near-full ROM before loading a plane Biceps curls light; progressive pec major/minor (avoid anterior-capsule-stress positions); subscap strengthening (push-up plus, cross-body diagonals, IR band 0/45/90, forward punch) Chest-level functional activities
IV - Overhead / return to activity 16-20 wk None Full pain-free ROM Overhead strengthening once sub-90 strength good; progressive weightlifting (15-25 reps); plyometrics/interval program if cleared; push-ups allowed but elbows not past 90 deg Throwing/overhead not before 4 months; pre-injury sport when cleared by MD

Active ROM start: AAROM wk 3, AROM ~wk 6. Strengthening start: scapular isometrics immediately; isotonic/RC strengthening ~wk 6. RTS: chest-level ~10-15 wk; overhead/throwing >=4 months; full/contact sport typically ~5-6 months (RAG cohorts: open Latarjet RTS averages ~6 months; bone-block soft-tissue/graft healing requires the 3-month minimum). ER milestones to advance: PE >=155 deg, ER within 8-10 deg of contralateral at 20 deg abd and >=75 deg at 90 deg abd.

Graft-protection summary (the Latarjet-specific precautions): no aggressive extension or extension+ER stretch early; protect conjoint tendon/biceps origin; protect subscapularis (slower ER + delayed IR strengthening if taken down); no pec flys/wide-grip bench/military press/behind-neck lat pulls; tricep dips avoided; osseous union ~6-8 wk gates heavier loading.

Key controversies & evidence flags

  1. Is a sling even necessary after open Latarjet? An RCT (Kourimpetis/PMC9969622, "Is sling immobilization necessary after open Latarjet surgery...") challenges routine immobilisation - because rigid bony fixation may not need the soft-tissue protection a Bankart does. This is the leading edge of "accelerated Latarjet." Evidence: STRONG (single RCT) - emerging, not yet standard.

  2. Accelerated Latarjet rehab / faster RTS. Multiple comparative studies (Beletsky 2020; Delgado 2025 matched-pair; Rogowski 2025 JSES) confirm Latarjet RTS is earlier than Bankart and that bony union (~3 months) - not soft-tissue - is the rate limiter. Rogowski (JSES 2025) argues functional dominant/non-dominant testing at 4.5 months predicts successful RTS better than time alone, supporting criteria-based acceleration. Evidence: MODERATE (good cohorts, no large RCT on the rehab pace itself).

  3. Contact/collision-sport return & procedure choice. Latarjet is often preferred in collision athletes (rugby) precisely because of bone block + dynamic sling. Tanaka 2022 / Hirose 2026 (Bristow vs Latarjet in rugby) and Gowd 2021 (JSES, RTS after Latarjet) inform RTS rates and timing; subluxation/pain after RTS more frequent in some Latarjet vs Bristow series. Contact RTS still generally ~5-6 months and criteria-based. Evidence: MODERATE cohort-level.

  4. Subscapularis split vs takedown-and-repair changes ER progression: takedown demands slower ER and delayed IR strengthening. Protocol explicitly defers to an intra-operative surgeon-defined ER "safe zone." Evidence: consensus / biomechanical rationale.

CITATIONS

Published rehabilitation protocols (URLs)

  • Brigham & Women's Hospital, Dept. of Rehabilitation Services - Anterior Stabilization of the Shoulder: Latarjet Protocol (orig. 2009, updated May 2016): https://www.brighamandwomens.org/assets/BWH/patients-and-families/rehabilitation-services/pdfs/shoulder-latarjet.pdf
  • Rehabilitation Guidelines for Latarjet/Coracoid Process Transfer (Eichinger, MD): https://www.josefeichingermd.com/pdf/rehab-guideline-for-latarjet.pdf
  • Rehabilitation Protocol - Latarjet (Coracoid Transfer/Eden-Hybinette), Lindsay Sports Med (2025): https://www.lindsaysportsmed.com/pdf/laterjet-and-edenhybinette-center-2025.pdf
  • Rehabilitation Protocol: Latarjet Coracoid Process Transfer (Utz, MD): https://www.christopherutzmd.com/pdfs/latarjet-protocol.pdf
  • Latarjet Procedure overview - Physiopedia: https://www.physio-pedia.com/Latarjet_Procedure

Local RAG corpus (article / journal / year)

  • Beletsky A, Cancienne JM, Manderle BJ, et al. A Comparison of Physical Therapy Protocols Between Open Latarjet Coracoid Transfer and Arthroscopic Bankart Repair. Sports Health. 2020. [protocol comparison - Latarjet RTS ~19.6 wk vs Bankart ~32.4 wk, p<0.001; AAROM ~6-8 wk]
  • Matache BA, Hurley ET, Wong I, et al. Anterior Shoulder Instability Part III - Revision Surgery, Rehabilitation and Return to Play - An International Consensus Statement. Arthroscopy. 2021;38(2). (Poses the open questions on immobilisation duration after coracoid transfer vs Bankart vs glenoid bone grafting.) [consensus]
  • Gowd AK, Liu JN, Polce EM, et al. Return to sport following Latarjet glenoid reconstruction for anterior shoulder instability. Journal of Shoulder and Elbow Surgery. 2021;30(11):2549-2559. [systematic review - RTS]
  • Rogowski I, Nove-Josserand L, Godeneche A, et al. Are the dominant-nondominant functional differences at 4.5 months after open Latarjet better predictors for successful RTS at 1 year than operated-nonoperated differences? Journal of Shoulder and Elbow Surgery. 2025;34(10):2338-2349. (3-month delay needed for graft healing; RTS ~6 months; criteria-based prediction.) [prospective cohort]
  • Delgado C, Calvo E, Valencia M, et al. Arthroscopic Bankart Repair Versus Arthroscopic Latarjet for Anterior Shoulder Instability: A Matched-Pair Long-Term Follow-up Study. Orthopaedic Journal of Sports Medicine. 2025. [matched-pair comparative]
  • Tanaka M, Hanai H, Kotani Y, et al. Open Bristow Versus Open Latarjet for Anterior Shoulder Instability in Rugby Players. Orthopaedic Journal of Sports Medicine. 2022. [comparative - contact athletes]
  • Hirose T, Tanaka M, Nakai H, et al. Comparing Bristow and Latarjet procedures for anterior shoulder instability in competitive rugby players. Journal of Shoulder and Elbow Surgery. 2026;35(4). [within-subject comparative]
  • Bonnevialle N, Girard M, Dalmas Y, et al. Short-Term Bone Fusion With Arthroscopic Double-Button Latarjet Versus Open-Screw Latarjet. The American Journal of Sports Medicine. 2021. [fixation/union]
  • Salem HS, Vasconcellos AL, Sax OC, et al. Intra-articular Versus Extra-articular Coracoid Grafts: A Systematic Review of Capsular Repair Techniques During the Latarjet Procedure. Orthopaedic Journal of Sports Medicine. 2022. (Documents post-Latarjet ER loss ~4.5-6.3 deg.) [systematic review]

Additional online RCT/evidence

  • "Is sling immobilization necessary after open Latarjet surgery for anterior shoulder instability? A randomized controlled trial." PMC9969622: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9969622/ [STRONG - RCT challenging routine immobilisation]
  • "Latarjet procedure enables 73% to return to play within 8 months depending on preoperative SIRSI and Rowe scores." PMC8298242: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8298242/ [cohort - RTS rate/timing]

Overall evidence grade for the phased protocol itself: CONSENSUS / institutional standard-of-care (Level V). The "sling necessary?" question is the only RCT-level datapoint; accelerated/criteria-based RTS rests on good comparative cohorts (Level III).

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