A week in Annecy
Dr Kenneth Cutbush spent a week in Annecy, France, with Dr Lafosse, a highly experienced shoulder surgeon who first described the arthroscopic Latarjet procedure.
What a visitation is
A visitation, or observership, is a period spent in another surgeon's unit watching their operating lists and clinics. It is a standing part of surgical practice after training: a surgeon who wants to adopt a technique travels to a unit that performs it regularly and watches it done repeatedly, rather than learning it from a paper or a single conference demonstration. A week gives enough cases to see how the technique is varied for different patients, and enough time out of theatre to ask about the reasoning behind those variations.
What the week covered
Dr Lafosse demonstrated recent developments in the arthroscopic Latarjet procedure. Over the course of the week he performed a range of operations, including reverse total shoulder replacement, primary anatomic shoulder replacement, rotator cuff repair and stabilisation surgery.
On the final evening Dr Cutbush dined at Dr Lafosse's home with his wife and fellows. A week-long visit of this kind is the most useful form of surgical education available, and this one was no exception.
The Latarjet procedure
The Latarjet is an operation for a shoulder that dislocates repeatedly. A piece of bone called the coracoid process is moved, with the tendon still attached to it, onto the front rim of the shoulder socket. That restores bone the socket has lost and adds a restraining sling across the front of the joint as the arm is raised. It is generally considered where the socket rim has been worn or broken away, so that repairing the torn soft tissue alone would leave too little bone to keep the joint in place. Describing it arthroscopically means performing that bone transfer through small portals with a camera, instead of through an open approach. Individual results vary.
Related information
- Our post on the Annecy Shoulder Course, and on the Latarjet and labral repair publication, which modifies Dr Lafosse's technique.
- Shoulder instability
- Latarjet and labral repair
- Anterior instability