The Latarjet procedure is a shoulder surgery that transfers a small piece of bone from one part of your shoulder blade to another, rebuilding the socket and preventing the shoulder from dislocating again. First described by a French physician in 1954, it’s typically recommended when the shoulder has dislocated multiple times and the socket has lost enough bone that a simpler soft-tissue repair won’t hold.
How the Procedure Works
Your shoulder socket (the glenoid) is a shallow, cup-shaped surface that the ball of your upper arm bone sits in. Repeated dislocations can chip away at the front rim of that socket, leaving it too shallow to keep the ball in place. The Latarjet fixes this by moving a finger-shaped piece of bone called the coracoid process, along with the tendons attached to it, from a nearby part of the shoulder blade to the damaged front edge of the socket. The graft is secured with screws.
This transfer stabilizes the shoulder through three mechanisms, sometimes called the “triple blocking” effect. First, the bone graft physically widens the socket, replacing what was lost. Second, the tendons that come along with the transferred bone act like a sling across the front of the joint, especially when the arm is raised and rotated outward, which is the position where most dislocations happen. Third, the transferred tissue reinforces the weakened capsule at the front of the joint, essentially patching the gap that was allowing the ball to slip out.
Who Needs a Latarjet Instead of a Bankart Repair
For a first-time or straightforward shoulder instability, surgeons usually start with a Bankart repair, which reattaches the torn soft tissue (the labrum) back to the socket rim. But when significant bone has been lost from the socket’s edge, a Bankart repair alone is more likely to fail. The threshold that tips the decision toward a Latarjet is generally around 13.5 to 15% glenoid bone loss, though this number is still debated among surgeons.
Other factors that favor a Latarjet include multiple failed prior stabilization surgeries, high-demand athletes in contact sports, and shoulders that show a combination of bone loss on both the socket side and the ball side (a defect called a Hill-Sachs lesion). Three-dimensional CT scans are the most accurate way to measure how much bone is missing and to plan the exact angle and placement of the transferred bone graft.
Latarjet vs. Bankart: How Outcomes Compare
Head-to-head comparisons consistently favor the Latarjet for preventing re-dislocation. In pooled research, the Latarjet had a recurrence rate of about 11.6% compared to 21.1% for Bankart repair, and post-surgical redislocation rates were roughly half: 5.0% versus 9.5%. Patients who had the Latarjet also reported better functional scores and less loss of outward rotation in the shoulder (about 11.5 degrees lost, compared to nearly 21 degrees after a Bankart).
Revision surgery rates were similar between the two procedures, at around 3 to 5%. Complications requiring reoperation were also comparable. The Latarjet isn’t automatically the better choice for everyone, though. It’s a more involved operation with its own set of risks, so surgeons reserve it for cases where a Bankart is unlikely to succeed.
Open vs. Arthroscopic Latarjet
The Latarjet can be performed through a traditional open incision or arthroscopically through several small incisions using a camera. The arthroscopic version causes less soft tissue damage, tends to be less painful in the early weeks, and may allow a slightly faster recovery. The tradeoff is that it takes roughly 30 to 40 minutes longer in the operating room, even in experienced hands, and demands a steep learning curve for surgeons. Return-to-sport rates end up being similar between the two approaches.
Recovery Timeline
You’ll wear a sling for about six weeks after surgery, including while sleeping. Physical therapy starts almost immediately, but in a very controlled way. During the first two weeks, you’ll do gentle pendulum swings and move your elbow and hand to prevent stiffness. Around weeks three and four, you’ll begin assisted shoulder movements using tools like a pulley or cane, along with light isometric exercises where you push against resistance without actually moving the joint.
By weeks five and six, you’ll start actively moving the shoulder on your own. True strengthening work begins around 13 weeks, and sport-specific training typically kicks off between 16 and 18 weeks. Most contact athletes return to play between 6 and 9 months after surgery, with studies reporting that 85 to 90% successfully get back to their sport.
Long-Term Success Rates
The Latarjet has strong durability over time. At two years, the redislocation rate is around 2%. At five years, it’s about 2.7%. Even at 10 to 15 years out, redislocation rates remain between 1 and 5%. In one North American study with an average follow-up of nearly 14 years, about 95% of patients had not dislocated again, and 94% had not needed any additional shoulder surgery.
Some patients do experience a sense of looseness or subtle instability without a full dislocation. Across long-term studies, this subjective feeling of instability is reported by roughly 16 to 17% of patients, a number that stays fairly stable whether you look at medium or long-term follow-up.
Risks and Complications
The most discussed complications involve the bone graft itself. Nonunion, where the transferred bone doesn’t fully fuse to the socket, occurs in roughly 5 to 9% of cases depending on how strictly it’s defined and how long patients are followed. In many of these cases the graft develops a fibrous attachment rather than full bony healing, which can still provide adequate stability. Graft fracture during or after surgery happens in about 1.5% of cases, and screw breakage occurs in under 5%.
Nerve injury is a concern because the procedure works close to the axillary nerve, which controls shoulder sensation and some muscle function. A large systematic review found a 1.4% rate of nerve or blood vessel injury, though individual series have reported higher rates. Most nerve injuries are temporary and resolve on their own. Overall, about 7% of patients require a reoperation at some point, and the most common reason (roughly a third of reoperations) is removal of screws that cause symptoms or sit in a poor position.
Arthritis Risk After Surgery
One of the most important long-term considerations is the development of shoulder arthritis. Because the procedure changes the shape of the joint surface, some degree of wear is expected over time. In a pooled analysis of studies with at least five years of follow-up, about 26% of patients showed radiographic signs of joint degeneration. The reassuring detail is that nearly 89% of those cases were mild, the kind of changes visible on imaging but not necessarily causing symptoms.
Significant arthritis (moderate to severe) develops in roughly 6% of patients at the five-year mark. With longer follow-up of 15 to 24 years, the numbers rise: one study found moderate-to-severe arthritis in 14% at 15 years, while another found it in 25% at 24 years. The single biggest risk factor for developing arthritis is an overhanging graft, where the transferred bone sits too far out on the socket surface and creates abnormal contact with the ball. Precise surgical placement of the graft is the key to minimizing this risk. Interestingly, patients with naturally loose or hypermobile joints appear to have some protection against post-surgical arthritis.