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Open Shoulder Stabilisation is a procedure to repair the damaged structure in the shoulder using a cut in the front of the shoulder. It is used when the degree of damage is such that an arthroscopic procedure cannot adequately or safely restore the stability to the shoulder joint.
Open shoulder stabilisation usually involves repairing the torn fibrous ring (labrum) at the front of the shoulder socket (glenoid). Other procedures may be necessary, such as repairing a glenoid fracture, tightening the loose capsular sleeve that surrounds the shoulder (capsular advancement), or repairing a tear of the capsule. In cases where the front of the glenoid has worn away, the missing bone may need to be reconstructed with a bone graft. The two main types of glenoid bone graft procedures involve either using bone from the iliac crest of the pelvis (Eden Hybinette procedure) or using the bony coracoid process that is close to the shoulder joint (Latarjet procedure).
Shoulder instability is a complicated problem and there are many factors that must be considered to determine the ideal treatment for a patient. At the Melbourne Shoulder and Elbow Centre, our surgeons are experts in the management of shoulder instability. They will assess your shoulder and advise you on the best procedure to manage your instability.
The Latarjet procedure is an operation that removes the coracoid process bone from its normal position on the shoulder blade (scapula), and attaches it to the front of the shoulder socket (glenoid). The coracoid has a tendon attached to it, and the new position of this tendon helps to reinforce the front of the shoulder and prevent it from dislocating.
The procedure is generally reserved for cases where the glenoid has worn down because of recurrent dislocations, or in cases of repeat dislocation following a different repair procedure.
The operation is performed through a short cut at the front of the shoulder. Patients generally go home from the hospital the day after their procedure.
You will be in a sling after surgery and then be referred to a physiotherapist. There are restrictions on how much you can move your shoulder in the weeks after surgery, which are necessary to prevent you from inadvertently damaging the repaired structures. Once the bone graft and soft tissues have healed, you will still require extensive physiotherapy to help retrain the stabilising muscles in your shoulder.
The Eden Hybinette procedure is an operation where a piece of bone is taken from the iliac crest of your pelvis and is attached to the front of the shoulder socket (glenoid). The procedure is generally used in young patients and in cases where the glenoid bone is worn down and other procedures have not worked. A modified version of the Eden Hybintte procedure uses a donor bone with the cartilage still attached (distal tibial allograft), rather than your own pelvis bone. The operation is performed through a short cut at the front of the shoulder.
Patients generally go home from the hospital the day after the procedure.
After surgery, you’ll be in a sling. You’ll then be referred to see a physiotherapist. There are restrictions on how much you can move your shoulder in the weeks after surgery; these are necessary to prevent you from inadvertently damaging the repaired structures. Once the bone graft and soft tissues have healed, you will still require extensive physiotherapy to retrain the muscles around the shoulder that help to keep it stable.
For more information on open shoulder stabilisation, we recommend contacting our surgeons for an initial consultation.
