Rehab Protocol: Latarjet Procedure

First 2 weeks:

Keep the arm in the sling for the first 2 weeks but open the sling a few times per day to allow the elbow to straighten. You need to sleep with the sling on as well. Apply ice packs to the shoulder during the first few days for 15-20 minutes at a time. To wash under your arm, bend forward while keeping your arm and shoulder relaxed. Gravity will cause your arm to go away from your body, allowing easy access to your armpit. Keep your dressing on until the first post-operative visit at 2 weeks. The dressing is waterproof, but try to keep it as dry as possible. If it becomes very soiled or soaked it should be replaced. It is normal to develop bruising over the shoulder after surgery. Please call Dr. Grey urgently if any redness appears around the dressing or if your pain suddenly worsens.

2 – 6 weeks:

The sling can be weaned after 2 weeks and activities of daily living can be performed as pain allows. Physiotherapy can be commenced: Gentle passive range of motion (physiotherapist moving the shoulder), active-assisted range of motion (using your opposite hand to move your arm) and active shoulder movements are performed as pain allows, without forcing the shoulder. Aim for a full range of motion by 6 – 8 weeks. Elbow flexion against resistance is not allowed at this stage, therefore don’t pick up any heavy objects yet. The second follow-up visit is at 6 weeks.

6 – 12 weeks:

Continue the range of motion exercises. Gradual strengthening is initiated at 8 weeks but avoid heavy lifting and placing high loads on the shoulder with the arms away from the body such as push-ups and bench-pressing. The physiotherapist will also work on scapular posture and proprioception exercises. You can start driving at about 8 weeks. Sports-specific exercises can be performed but contact onto the shoulder is not allowed yet. Another follow-up visit is scheduled at 3 months to repeat X-rays.

After 12 weeks:

The physiotherapist will focus on further strength and endurance training. Rugby players can only take contact onto the shoulder after 3-4 months, once the bone block has united onto the glenoid. Most rugby players will be able to return to competitive rugby at about 4-6 months. Manual laborers will be able to return to normal duty at about 3 months.