The annual dinner meeting
Dr Kenneth Cutbush attended the Queensland Shoulder Society's annual dinner meeting in November 2014.
The guest speaker was Dr Greg Hoy of Melbourne, then president of SESA, who described the Victorian experience with shoulder instability surgery in AFL athletes.
The societies involved
The Queensland Shoulder Society is a state-level group of surgeons with a shoulder practice. Meetings of that kind are where cases, techniques and new evidence are discussed among people who see the same problems in the same city, and an annual dinner meeting combines a scientific programme with the social function, usually with an invited guest speaker from interstate. SESA is the Shoulder and Elbow Society of Australia, the national subspecialty society for the shoulder and elbow, which runs the annual scientific meeting at which Australian shoulder research is presented.
Instability in contact athletes
Shoulder instability means the ball of the joint comes out of its socket. It is common in contact sport because the shoulder gets loaded in positions it is not built to resist. A first dislocation usually tears the labrum, the cartilage rim that deepens the socket, and may also take bone from the front rim. Once that has happened the shoulder can give way again with less force each time, and for a footballer the question becomes which repair will hold up against being tackled repeatedly.
The two broad options are a soft tissue repair, in which the torn labrum and capsule are reattached to the rim of the socket, usually through keyhole portals, and a bone block procedure such as the Latarjet, in which the coracoid process is moved onto the front of the glenoid to deepen the socket and act as a physical stop. Individual results vary.
The debate
Dr Hoy and Dr Cutbush then debated the motion "The Latarjet operation is the procedure of choice in contact athletes".
That is a debate proposition rather than a settled conclusion, and the arguments on both sides are real. A bone block is more robust against the demands of contact sport, but it is a larger operation with its own complications, and a soft tissue repair is sufficient for many shoulders. Which is appropriate depends on the individual.
Related information
- Our shoulder instability page
- Our anterior instability page
- Our stabilisation page
- Our post on the Latarjet debate at the RNS Shoulder Meeting