Alterique Gilbert Update

[CAHUSKY]

The Latarjet is now the standard revision surgery procedure for failed stabilization procedures. It accomplishes two things. First, it adds bone to the front of what is usually a deficient socket, after the front edge of the socket fractures during the initial or subsequent dislocations. Second, by tensioning the lower half of the subscapularis muscle, in the front of the shoulder, it creates a "sling effect" where the subscap is tighter and more in control of the shoulder as the arm is brought up into the danger position.

So what's done is to take about 2.5 cm of the coracoid along with the attached coracobrachialis and short biceps tendons and transfer the bone through the middle of the subscap to the front of the glenoid, or shoulder socket. It's usually held in place with two screws. Believe it or not, it can be done arthroscopically, though most surgeons do it open. There are a lot that won't/don't do this procedure, hence the referral to Dr. Provencher. Success requires good position for the bone block and solid healing of bone-to-bone. If those two are achieved, it's about 95% successful.

If not ...

It's not often I read the Boneyard and think I'm not nearly as smart as the guy who penned that post. This is one of those times. Thanks for your knowledge Doc.

 

[AdamaNation]

The Latarjet is now the standard revision surgery procedure for failed stabilization procedures. It accomplishes two things. First, it adds bone to the front of what is usually a deficient socket, after the front edge of the socket fractures during the initial or subsequent dislocations. Second, by tensioning the lower half of the subscapularis muscle, in the front of the shoulder, it creates a "sling effect" where the subscap is tighter and more in control of the shoulder as the arm is brought up into the danger position.

So what's done is to take about 2.5 cm of the coracoid along with the attached coracobrachialis and short biceps tendons and transfer the bone through the middle of the subscap to the front of the glenoid, or shoulder socket. It's usually held in place with two screws. Believe it or not, it can be done arthroscopically, though most surgeons do it open. There are a lot that won't/don't do this procedure, hence the referral to Dr. Provencher. Success requires good position for the bone block and solid healing of bone-to-bone. If those two are achieved, it's about 95% successful.

If not ...

So the real focus here is strong bone

 

[zls44]

The Latarjet is now the standard revision surgery procedure for failed stabilization procedures. It accomplishes two things. First, it adds bone to the front of what is usually a deficient socket, after the front edge of the socket fractures during the initial or subsequent dislocations. Second, by tensioning the lower half of the subscapularis muscle, in the front of the shoulder, it creates a "sling effect" where the subscap is tighter and more in control of the shoulder as the arm is brought up into the danger position.

So what's done is to take about 2.5 cm of the coracoid along with the attached coracobrachialis and short biceps tendons and transfer the bone through the middle of the subscap to the front of the glenoid, or shoulder socket. It's usually held in place with two screws. Believe it or not, it can be done arthroscopically, though most surgeons do it open. There are a lot that won't/don't do this procedure, hence the referral to Dr. Provencher. Success requires good position for the bone block and solid healing of bone-to-bone. If those two are achieved, it's about 95% successful.

I mean, I could've told you all that.

 

[Fishy]

I mean, I could've told you all that.

I would have suggested some drywall screws in the shoulder blade, but their way might work, too.

 

[uconnbill]

I thought duct tape, but what do I know

 

[Jimdish255]

Just posted this in another AG thread - AG had the surgery at Steadman Hawkins, a place I suggested in a post eons ago, in Vail, CO, one of the premier knee / shoulder facilities for high level athletes. Halls are lined with pix of pro athlete patients from all sports. Hawkins did the shoulders, but has retired. I visited with Hawkins in the 90s on rotor cuff issue - he was great. AG could not have picked a better place. If this doesn't work, ... However, he's prob not enjoying the slopes, but this is VERY good sign.

Any word on AG's activity level now that we're a couple months removed from the procedure?

 

[8893]

It's not often I read the Boneyard and think I'm not nearly as smart as the guy who penned that post.

Really? I would have figured that to be a more frequent occurrence for you.