On the instability faculty
On the faculty for an ISAKOS session on instability in Shanghai, presenting on the arthroscopic Latarjet procedure, covering the indications for it and the key technical issues.
Speaking alongside Dr Hiroyuki Sugaya of Japan, Richard Ryu of the United States and Chun Jiang of China.
About ISAKOS
ISAKOS is the International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine, an international body for surgeons working in arthroscopic and sports related orthopaedics. Its congress is held every two years and draws surgeons from a wide range of countries, which is part of the reason faculty for a single session are usually assembled from several continents.
The arthroscopic Latarjet procedure
The Latarjet procedure is an operation for anterior shoulder instability, in which the ball of the shoulder repeatedly slips forward out of its socket. A small piece of bone, the coracoid process, is transferred with its attached tendon to the front of the socket. This deepens a socket that has lost bone and adds a restraint across the front of the joint.
The operation has traditionally been performed open, through an incision at the front of the shoulder. The arthroscopic version achieves the same result through small portals with a camera inside the joint. It is technically demanding, which is why a session on it spends as much time on technique as on anything else. Individual results vary.
What the indications are
In surgical discussion, the indications for an operation are the circumstances in which it is the appropriate choice. For instability that means weighing how much bone has been lost from the socket, whether the labrum alone can be repaired, whether there is a defect in the ball of the joint, the patient's age and what they do, and whether a previous repair has already failed.
Deciding between the available operations is as much of the work as performing them, and it is the part that varies most between surgeons. That is why conference sessions are built around it, and why a faculty is deliberately drawn from surgeons who do not all approach the problem the same way.
Related information
See our shoulder instability page and our post on the ISAKOS congress programme. See also our anterior instability, Latarjet with labral repair and stabilisation pages.