Latarjet Procedure — Anterior Labral Repair / Open Capsulorrhaphy with Bone Block (Latarjet or Tibial Plafond Allograft)

UCLA Department of Orthopaedic Surgery - Sports Medicine · Thomas Kremen MD

Weight-Bearing

N/A (upper extremity)

Key Restrictions

Sling without abduction pillow x 8 wks; no pendulum exercises; no active ROM x 8 wks; PROM elevation to 90° x 4 wks then 120° wks 4-8; ER to 30° at 0°/45° abduction x 4 wks then 60° wks 4-8; no ER at 90° abduction until 8 wks; no IR behind back x 8 wks; aquatic therapy begins at 8 wks; full ROM target by 12 wks

Timeline & Phases

Phase 1 (0-8 wks): sling without abduction pillow, no pendulums, no active ROM, PROM: elevation 90° (×4 wks) → 120° (wks 4-8), ER 30° at 0°/45° (×4 wks) → 60° (wks 4-8), no ER at 90° abduction, IR to abdomen, no IR behind back, aquatic therapy at 8 wks | Phase 2 (8-12 wks): wean sling, PROM → full ROM, elevation to 140°, ER 70° at 0°/45° and 60° at 90° abduction, IR thumb to L1, aquatic therapy without ROM limits | Phase 3 (12-16 wks): full ROM target by 12 wks, isometric ER/IR at 0°/45°/90°, rhythmic stabilization, AAROM → AROM elevation in supine, PNF D1/D2, periscapular strengthening, light theraband resistance, aquatic therapy with paddle/webbed gloves | Phase 4 (16-20 wks): progress strengthening with weight, gym machines (chest press/rowing/lat pulldown), IR/ER at 90° abduction, isokinetics 120-240°/sec | Phase 5 (20-28 wks): sport-specific functional progression, interval sport programs, plyometrics with pitchback, advanced strengthening

Notes

Covers both Latarjet and tibial plafond allograft bone block procedures; sling WITHOUT abduction pillow (compare to anterior/posterior labral repair which uses sling WITH pillow); no active ROM x 8 wks is the most restrictive of Kremen shoulder protocols; Phase 1 extends to 8 wks (vs 4 wks for labral repair); ER at 90° abduction restricted until 8 wks; full ROM target by 12 wks (vs 8 wks for labral repair); isokinetics begin 16-20 wks; interval sports and plyometrics 20-28 wks; Kremen MD UCLA PatientPop practice site

Surgeon / Author

Thomas Kremen MD