The arthroscopic Latarjet is a new technique developed by Dr Laurent Lafosse and is used for the management of complex shoulder instability. It is performed in situations where a labral repair is not possible or has a high risk of re-dislocation. The indications for a Latarjet procedure include shoulder dislocation associated with:

• Glenoid bone fracture
  
• A large Hill Sach’s fracture of the humeral head
  
• An engaging Hill Sach’s fracture
  
• Previous shoulder reconstruction, labral repair or stabilisation surgery.
  
• Chronic or recurrent shoulder instability
  
• Participation in contact sports

The open Latarjet procedure was developed in France and has been used for approximately 40 years for the management of complex instability cases. Rather than repairing the torn labrum, the Latarjet procedure involves placing a bone graft (the Coracoid process) onto the front of the glenoid and fixing it in position with two screws. The bone graft and its attached tendon prevent the shoulder dislocating, thereby replacing the function of the labrum. The Latarjet procedure has a mush lower risk of re-dislocation than a labral repair.

Recently the arthroscopic or keyhole technique has been developed. The advantage of the keyhole technique is smaller scars, less post-operative pain, lower risk of infection and greater accuracy with graft positioning.

Dr Piper trained with Dr Lafosse in France in order to learn this new procedure and offer it to patients in Australia.