Latarjet Procedure — Anterior Stabilization — Latarjet Procedure

Mammoth Orthopedic Institute / Sierra Park PT · Brian Gilmer MD (US Ski Team Physician); Karly Dawson PA-C; Jennifer McMahon PT

Weight-Bearing

N/A (shoulder) — sling, remove only for showering; wean by end of wks 4-5

Key Restrictions

Sling until wks 4-5; no AROM Phase I early; ER limited to 25 deg Phase I early, 45 deg Phase I late; no lifting or WB through operative shoulder; no scaption with IR (empty can) Phase I late+; no activities loading anterior capsule (push-ups, pec flys) Phase I late+; no heavy lifting or plyometrics Phase II; no overhead throwing until 4 months or MD cleared; avoid contact sports Phase III; no triceps dips, wide grip bench press, military press, or lat pulls behind head Phase IV; avoid excessive anterior capsule stress throughout

Timeline & Phases

4 phases with sub-phases: Phase I Early (0-4 wks, sling, PROM: ER 0-25 deg + IR 45 deg, scapular clocks progressing to isometrics, ball squeezes), Phase I Late (4-6 wks, progress PROM, wean sling by wks 4-5, AROM initiation, light waist-level activities), Phase II (6-10 wks, full elevation in scapular plane, AA/AROM, scapular retractor/upward rotator strengthening, RC ER/IR tubes, prone rowing at 30/45/90 ABD), Phase III (10-15 wks, normalize strength/endurance, chest-level functional activities, subscapularis strengthening — push-up plus/IR band/forward punch/cross-body diagonals), Phase IV (16-20 wks, return to overhead work/strenuous activities, plyometrics if MD cleared, emphasis on deltoid/lats/pec major)

Notes

References Brigham and Women's Hospital; Jennifer McMahon PT 2/15/2017; Gilmer MD 2017; Phase II progression criteria: passive ER within 8-10 deg contralateral at 20 ABD and ER >=75 deg at 90 ABD; "always see your elbows" Phase IV rule (avoid triceps dips, wide grip bench, behind-neck press); empty can (scaption with IR) explicitly prohibited; subscapularis strengthening specifically addressed Phase III; coracoid transfer procedure requiring anterior capsule protection throughout

Surgeon / Author

Brian Gilmer MD (US Ski Team Physician); Karly Dawson PA-C; Jennifer McMahon PT

Published

2017