Latarjet Surgery
in Rockhampton

What is going on

The Latarjet procedure addresses shoulder instability that cannot be reliably managed by soft-tissue repair alone. The most common indication is significant bone loss from the front of the glenoid, where the socket has lost a critical proportion of its width through repeated dislocations. Without enough bone, a soft-tissue Bankart repair has a high failure rate. The Latarjet addresses this by transferring a piece of the coracoid process — a hook-shaped projection of the scapula — to the front of the glenoid, where it both replaces missing bone and provides a sling effect through the conjoint tendon attached to it. The result is a more durable construct in high-demand and contact-sport patients.

Not sure if this is the right diagnosis? The shoulder pain hub and shoulder injury hub triage the differential by anatomical location.

What the operation involves

The Latarjet procedure is performed through an open or arthroscopic approach depending on the patient and the surgical findings. The coracoid process is osteotomised — cut from its base — and transferred through a split in the subscapularis tendon to the anterior glenoid rim, where it is fixed with two screws. The conjoint tendon attached to the coracoid creates a dynamic sling that further stabilises the joint when the arm is in the at-risk position. The procedure usually takes 90 to 120 minutes under regional and general anaesthesia; patients spend one to two nights in hospital. Full clinical detail is on the education page, and the shoulder instability education page covers the underlying condition.

For full clinical detail — incision, anaesthetic, post-operative instructions and the printable patient handout — see the latarjet procedure education page or the shoulder surgery overview.

How this case is handled

Latarjet is one of Dr Hirpara's specific subspecialty interests — the technique was a substantial part of his Brisbane Hand & Upper Limb Clinic shoulder fellowship under Ass. Prof Cutbush, and he co-authored the published technique paper on the procedure (Cutbush K, Hirpara KM. *Arthroscopic Latarjet Stabilization of the Shoulder With Capsulolabral Repair*. Tech Shoulder Elbow Surg. 2015). Shoulder physiotherapy through George Labor in the same suite is integrated into the post-operative pathway.

Fees, Medicare rebates and the surgery-quote process are on the fees page. The case for seeing a fellowship-trained surgeon — and what fellowship training adds — is set out separately. GPs can find the referral pathway, urgency triage and what to include in the letter on the referrer page.

What this operation is billed under

The procedure is covered by the following Medicare Benefits Schedule items. Surgeon, anaesthetist, assistant, hospital and prosthesis fees are quoted separately and in writing before surgery — see the fees page for the practice's quote process and an explanation of why surgical fees follow the Australian Medical Association schedule. Surgery does not proceed without itemised written informed financial consent.

Item 48959 Latarjet procedure

Used when a Latarjet is performed, whether open or arthroscopic

Patient questions we hear most

• Why a Latarjet rather than an arthroscopic repair?

  The Latarjet procedure is recommended when bone is missing from the front of the glenoid — broadly more than 15–20% of the glenoid width — or when a previous soft-tissue stabilisation has failed. Without enough bone in the socket, a soft-tissue repair fails at high rates because the construct cannot prevent the humeral head from sliding off the deficient front edge. The Latarjet replaces the missing bone with a transferred piece of the coracoid and adds a soft-tissue sling effect; it offers lower recurrence rates than arthroscopic stabilisation in high-risk patients.

• What's the recurrence rate after a Latarjet?

  Published recurrence rates after Latarjet are markedly lower than for arthroscopic Bankart repair in high-risk patients — generally in the low single-digit percentage range at medium-term follow-up. The Latarjet was originally developed to address the very patients in whom soft-tissue repair was failing, and the published evidence consistently shows superior stability outcomes in contact-sport athletes and patients with bone loss. Outcomes are best when the surgery is correctly indicated and the bone graft heals to the glenoid; the consultation discusses individualised risk factors.

• What are the specific risks of a Latarjet?

  The Latarjet has a few risks specific to its bone-block nature: graft non-union or graft lysis (the transferred bone failing to heal or progressively resorbing), screw or hardware-related problems, and injury to nearby structures (most importantly the musculocutaneous nerve and the axillary nerve, both of which run close to the operative field). Loss of external rotation can occur where the subscapularis is split. The reported complication rate in experienced hands is acceptable; the consultation discusses risk in the context of the patient's own circumstances.

• When can I return to contact sport after a Latarjet?

  Most surgeons hold contact sport until the bone graft has consolidated — typically six to nine months from surgery, confirmed on follow-up imaging. Non-contact sport is usually possible at four to six months. The Latarjet is the operation that allows the most reliable return to contact sport at competitive level, which is why it is preferred in high-demand patients despite being more invasive than arthroscopic stabilisation. The post-operative review schedule includes a clearance discussion at three, six and nine months.

• How much does a Latarjet cost? What does Medicare cover?

  The Latarjet procedure is performed under regional and general anaesthesia, so a separate anaesthetist gap applies on top of the surgeon and hospital fees. The practice quotes the surgical fee in writing before booking — the Medicare item (48959), the rebate and the out-of-pocket gap each shown separately. Dr Hirpara's surgical fees follow the Australian Medical Association schedule, which is higher than the Medicare scheduled fee; the fees page explains why. Surgery does not proceed without itemised written informed financial consent.

• Open or arthroscopic — which is better?

  Both approaches achieve the same surgical goal: the coracoid is osteotomised, transferred to the anterior glenoid, and fixed with screws. Published outcomes are broadly similar. The open approach has the longer track record and is the more commonly performed worldwide; the arthroscopic approach offers smaller incisions and the ability to address concomitant intra-articular pathology arthroscopically in the same operation. Dr Hirpara has published on the arthroscopic technique and offers both approaches; the choice is made individually depending on the patient's anatomy, prior surgery and the specific findings.

• Do I need physiotherapy after a Latarjet?

  Yes — shoulder physiotherapy is integrated into the post-operative pathway and is critical to the final result. The schedule runs gentle range of motion in the first six weeks (under sling protection), active motion from six weeks, scapular and rotator cuff strengthening from twelve weeks, and sport-specific rehabilitation from four to six months. Bone graft consolidation is monitored on follow-up imaging at three to six months. Shoulder physiotherapy is provided by George Labor in the same suite as Dr Hirpara's rooms.

More general questions about appointments, fees and the practice on the FAQ page.