Why I picked the Latarjet procedure -- A little bit of context

I decided to write about my experience with the Latarjet procedure because I found it very hard to find information from patients that underwent this (still today) very specific treatment of chronic recurrent shoulder instability. I am 32 years old and live in Frankfurt, Germany.

I personally have had a long history of shoulder instability. It all started when I was 17 and dislocated my right shoulder for the first time while playing Badminton in physical education at school. And no, I was not falling… Just performing an overhead strike with a lot of force and there went my shoulder… My teacher was shocked and didn’t know what to do so we called the ambulance who put me into full anesthesia on the spot and repositioned the shoulder. I woke up in the hospital with some pain, but the shoulder seemed to be fine to me. I underwent x-rays and MRI examination and the diagnosis was that the labrum had be torn apart and the doctors suggested to perform an arthroscopic stabilization which is broadly known as the “Bankart repair”. First, I didn’t want to undergo surgery but after dislocating the shoulder five more times, sometimes even during normal daily activities like stretching in bed, I decided that I needed to do something about it. I had my first surgery in 2004 which went well, and I went through a lengthy recovery process. After 9 months I was ready to participate in sports again.

I went back to playing football (soccer) and in one of the first training sessions, I dislocated it again… I was not able to reposition it myself, so we had to drive to an ER to get it repositioned. After this incident I stopped playing football and tried to build up muscles to support the stability and avoid another surgery.  That went fine until 2 years later when I was just cleaning the floor, trying to get rid of a particularly annoying spot when I dislocated it during that activity… Again, I was not able to reposition it myself and had to take public transport to get to the hospital. Imagine the looks on people’s faces who saw me with this weirdly positioned shoulder. After this incident I decided to have another surgery in 2006. The surgeon told me before surgery that he was not sure if they could do a Bankart-repair again or if they would have to extract a little piece of hip bone and transfer it to the shoulder to increase the surface area of the socket. So, the first thing I did after waking up was to check if there was a cut around my hip which I luckily didn’t have. They performed another arthroscopic Bankart repair. I had to stay a few days in hospital and underwent the same rehabilitation program as before. This time it all seemed to go well. I went back to snowboarding, went to the gym, started doing body weight training and was using my shoulder with no issues in my daily life. I had lost a few degrees of outside and overhead rotation but that did not restrict me in my activities.

In 2014, I went on a business trip to California and I was lucky to have one free weekend to spend. A coworker and I rented a car and drove down the highway 1 from San Francisco to Monterey. Approximately an hour before Monterrey we stopped at a nice beach. The weather was nice, and we decided to go for a swim. There were some decently sized waves on this day and we enjoyed being in the sea. My coworker decided to leave the water after 15 minutes and I stayed to catch a few more waves. When a bigger wave was approaching, I somehow got caught by surprise and got pushed under water when I suddenly felt this familiar pain in my right shoulder. I knew that I had dislocated my shoulder, but my priority was to get out of the water into safety. Once I was outside of the water I was able to verify that I had dislocated my shoulder. I tried to reposition it myself, but there was no way it was getting back into its position. Here I was, in California, at the beach, in summer with a dislocated shoulder. It took us approximately one hour to get to the emergency room in Monterey.

After handing in my credit card the doctors happily treated me. I got some painkillers and muscle relaxation medication and then they were able to reposition the shoulder. They also took an x-ray after the reposition to verify no new damages to the bone structure. Apart from my Hill-Sachs lesion (red arrow) there's nothing fancy to see here.

Back in Germany, I had an MRI scan done, but decided against having another surgery. According to the doctors, there was no sign of new damage to the glenoid or the bone.  However, a doctor told me that he was able to see signs of bone bruise which seem to be a bit older already. After a few weeks of taking it easy I went back to doing sports, body weight training and had no issues with feelings of instability in my daily life.

In 2017, I decided to sign up for cross fit because I was looking for a new workout experience. I was very careful with exercises that involved lifting weights above my head and I knew my shoulder was in danger. Even though I was very careful, one day it happened again. I was doing the last repetition of snatches and was lifting the weights over my head when I suddenly felt pain in my right shoulder, screamed and immediately dropped the weights. My shoulder had dislocated again. After a few seconds, however, I was able to reposition the shoulder myself.  I even went home cycling and met some friends right after the accident. The next week, I started seeing doctors to check if there had been any new damage to my shoulder. When the MRI scans came in, the doctors told me that there is severe damage in my shoulder and I won’t be able to control instability without having another surgery. I started looking for shoulder specialist to get several opinions of what the right approach would be.