Open and arthroscopic Latarjet give broadly similar results for recurrent shoulder dislocation – similar stability, function and complication rates in pooled studies – with the arthroscopic version offering less early pain and the open version being simpler, quicker, cheaper and slightly less complication rates. The surgeon's experience with the chosen technique matters more than the technique itself.
The Latarjet procedure is one of the most reliable operations for recurrent shoulder dislocation, especially when the socket has lost bone. It was traditionally performed as open surgery; since 2007 it has also been done arthroscopically. This guide from the shoulder team at Sports Orthopedics Institute compares the two approaches using the best available evidence.
Key takeaways
- Stability: recurrence after either technique is low, and a recent meta-analysis found no difference between them.
- Function and pain: long-term scores are similar; arthroscopy may offer less pain in the first few weeks.
- Complications: overall rates are similar; the meta-analysis found a lower non-union rate with the arthroscopic approach.
- Learning curve: arthroscopic Latarjet is technically demanding, with operating time and complications falling after roughly the first 30 cases.
- Cost: arthroscopic Latarjet usually costs more because of specialised instruments and implants.
- Evidence quality: most comparisons come from cohort studies, with very few randomised trials, so conclusions are still evolving.
What Is the Latarjet Procedure?
The Latarjet transfers a small piece of bone – the tip of the coracoid, with its attached tendons – to the front of the shoulder socket, where it is fixed with screws or buttons. This restores the bony rim of the socket and adds a “sling” effect from the transferred tendons, making repeat dislocation much less likely.
Who needs a Latarjet?
- Recurrent anterior shoulder dislocation with significant bone loss from the front of the socket (glenoid)
- A large or “engaging” dent in the ball of the shoulder (Hill-Sachs lesion)
- Contact and collision athletes, such as rugby, kabaddi and wrestling players, at high risk of failure after a soft-tissue repair
- Failed previous stabilisation, such as a Bankart repair
Why not a Bankart repair?
For patients with significant bone loss or multiple dislocations, the Latarjet has lower recurrence than arthroscopic Bankart repair. One 2025 meta-analysis reported recurrence of 4.2% after open Latarjet compared with 11.8% after arthroscopic Bankart repair (Clinical Medicine Insights, 2025). Long-term, a 20-year follow-up of open Latarjet reported a recurrence rate of only 5.9% (Current Reviews in Musculoskeletal Medicine, 2024).
How Open and Arthroscopic Latarjet Differ
Both operations do the same thing to the shoulder; they differ in how the surgeon gets there.
Open Latarjet
Performed through an incision of about 5–7 cm at the front of the shoulder. The surgeon sees and handles the coracoid and the socket directly, splits the subscapularis muscle, and fixes the graft with screws. It has been refined over several decades and has the longest track record.
Arthroscopic Latarjet
First described by Lafosse and colleagues in 2007, it is performed entirely through several small portals using a camera and specialised instruments. The surgeon prepares the socket, cuts and transfers the coracoid, and fixes it with screws or suture-button devices. It also allows the surgeon to inspect and treat other problems inside the joint at the same time. Guided systems have been developed to improve reproducibility.
Practical differences
|
|
Open |
Arthroscopic |
|---|---|---|
|
Incision |
One incision of about 5–7 cm |
Several small portals |
|
View |
Direct |
Magnified camera view; can treat other joint problems |
|
Technical difficulty |
Moderate |
High; steep learning curve |
|
Operating time |
Usually shorter |
Usually longer, especially early in a surgeon's experience |
|
Instruments and implants |
Standard |
Specialised; more expensive |
Outcomes: Stability, Function and Return to Sport
Pooled data show no meaningful difference in stability or function between the two approaches; individual studies differ on small details.
The largest meta-analysis
A recent systematic review and meta-analysis of comparative studies found no differences between open and arthroscopic Latarjet in pain, Rowe and Walch-Duplay scores, external rotation, persistent apprehension, instability, recurrence, revisions for instability, overall complications, infection, haematoma, graft or screw complications, or arthritis. The arthroscopic group had a lower non-union rate (Deng et al., meta-analysis).
Individual comparative studies
- Range of motion: a cohort study of patients with glenoid bone loss followed for a mean of 30.5 months found slightly less internal rotation loss after open surgery (9° vs 14°) and better instability-specific quality-of-life (WOSI) scores after arthroscopic surgery; overall clinical and radiographic outcomes were similar (Arthroscopy, 2020).
- Recurrence in comparative series: one study reported recurrence of 6.2% after open and 4.8% after arthroscopic Latarjet, with similar revision rates.
- Small randomised trial: a 30-patient randomised study found equally improved results with both techniques, with better recovery of rotation after the arthroscopic procedure (Zaporozhye Medical Journal, 2020).
A note on collision athletes
A meta-analysis of 896 patients presented at the Arthroscopy Association of North America in 2019 found non-significant trends favouring open Latarjet for function, external rotation and recurrence, and a trend towards more revisions and nerve complications after arthroscopic Latarjet (Healio, 2019). These were trends, not statistically significant differences.
Bottom line: both techniques produce stable shoulders and good function in most patients. Higher-quality randomised trials with long follow-up are still needed.
Graft Position, Healing and Early Pain
Precise placement of the bone block is central to success: too far inward (medial) increases recurrence; too far outward (lateral) increases the risk of later arthritis.
- Graft position: both techniques can achieve accurate positioning. The 2020 cohort study found similar graft positions, with lateral placement in 13% of open and 9% of arthroscopic cases, but better screw angles after open surgery (11° vs 19°) (Arthroscopy, 2020). Older radiographic studies of open Latarjet reported frequent graft malposition, and arthroscopy offers a direct view of the socket during placement (Current Reviews in Musculoskeletal Medicine, 2024).
- Bone healing and resorption: some shrinkage of the graft is common after both techniques. The meta-analysis above found fewer non-unions after arthroscopic Latarjet.
- Early pain: arthroscopic Latarjet is reported to be less painful in the early weeks, but this difference largely disappears by about one month (PubMed review).
Complications and the Learning Curve
The Latarjet is a powerful but demanding operation by either route; complications are lower in experienced hands.
Possible complications (both techniques)
- Recurrent instability
- Loss of external rotation
- Bone block failing to heal (non-union), fracturing or resorbing
- Screw or implant problems needing removal
- Nerve injury (the musculocutaneous and axillary nerves lie close by)
- Infection and haematoma
- Later arthritis, particularly if the graft sits too far outward
A meta-analysis focused on early outcomes of arthroscopic Latarjet reported an overall complication rate of 16.5%, conversion to open surgery in 2%, recurrence in 2.5% and revision surgery in 5.6%, and noted the procedure is technically demanding and more expensive in implants (Cerciello et al., 2019).
The learning curve
- Arthroscopic: in one series, operating time, complications and hardware problems fell significantly after the first 30 cases, and all recurrences occurred in the first group (PubMed). A multi-surgeon analysis found operating time stabilised after 30–50 cases (JSES). Another series of 103 shoulders found complications fell from 16 in the first 25 patients to 4 in the last 25 (Bøe et al.).
- Open: a learning curve also exists for open Latarjet, though it is generally considered shorter.
Open vs Arthroscopic Latarjet at a Glance
|
Outcome |
Open Latarjet |
Arthroscopic Latarjet |
What the evidence shows |
|---|---|---|---|
|
Recurrence |
Low; 5.9% at 20 years in one long-term study |
Low in experienced hands |
No difference in pooled studies |
|
Function scores |
Good to excellent |
Good to excellent |
No difference in pooled studies |
|
Early pain |
Slightly more |
Slightly less |
Difference fades by about one month |
|
Range of motion |
Good |
Good; some studies show better rotation |
Small, inconsistent differences |
|
Graft and screw position |
Accurate; better screw angles in one study |
Accurate; direct view of the socket |
Both can be accurate |
|
Non-union |
Slightly higher in pooled data |
Lower |
Favours arthroscopic |
|
Overall complications |
Similar |
Similar; higher early in the learning curve |
No difference in pooled studies |
|
Operating time |
Usually shorter |
Longer, especially early on |
Favours open |
|
Cost |
Lower |
Higher (implants and instruments) |
Favours open |
|
Long-term data |
Decades |
Shorter follow-up |
Favours open |
Recovery and Rehabilitation
Rehabilitation is broadly similar after both techniques, because the bone block needs the same time to heal.
|
Phase |
Typical timing |
Focus |
|---|---|---|
|
Protection |
Weeks 0–3 |
Sling for comfort, gentle passive and assisted movement, avoid forced external rotation |
|
Restore movement |
Weeks 3–6 |
Progressive active range of motion, early scapular and rotator cuff activation |
|
Strengthening |
Weeks 6–12 |
Progressive strengthening once imaging suggests the graft is healing |
|
Return to sport |
Months 3–6 |
Sport-specific training; contact and overhead sport usually from 4–6 months once strength, motion and confidence are restored |
Many patients return to desk work within one to two weeks. Exact timelines depend on your surgeon's protocol, your sport and graft healing on follow-up imaging.
Which Approach Is Right for You?
For most patients, the best Latarjet is the one your surgeon performs most often and most reliably.
Arthroscopic Latarjet may be preferred when:
- The surgeon is experienced and past the learning curve
- Other problems inside the joint also need treatment
- Minimising early pain and the scar is a priority
Open Latarjet may be preferred when:
- Revision surgery, previous open surgery or unusual anatomy is present
- Very large bone defects require additional reconstruction
- Cost is a significant factor
- The surgeon's expertise and outcomes are strongest with the open technique
Questions to ask your surgeon
- Why do I need a Latarjet rather than a Bankart repair?
- Which technique do you use, and how many have you performed?
- What are your recurrence and complication rates?
- How will you check the position and healing of the bone block?
- When can I return to work and to my sport?
- What is the cost difference between the two approaches?
How Sports Orthopedics Institute Can Help
We assess your shoulder in detail and recommend the stabilisation that best suits your bone loss, sport and goals.
- Precise assessment: examination, X-rays and 3D CT to measure glenoid bone loss and the Hill-Sachs lesion.
- The full range of stabilisation: arthroscopic Bankart repair, remplissage, and Latarjet.
- Return-to-sport planning: structured rehabilitation with objective criteria for contact and overhead athletes.
Shoulder keeps dislocating? Book a consultation with our shoulder specialists in Bengaluru.
Frequently Asked Questions
Is arthroscopic Latarjet better than open Latarjet?
Not clearly. Pooled studies show similar stability, function and complication rates. Arthroscopic Latarjet may offer less early pain and a lower non-union rate; open Latarjet is quicker, cheaper and has the longest track record.
Which has a lower recurrence rate?
Recurrence is low after both, and a meta-analysis of comparative studies found no difference. Surgeon experience and accurate graft placement matter most.
Is arthroscopic Latarjet less painful?
Usually in the first few weeks, but the difference largely disappears by about one month.
How long does each operation take?
Open Latarjet usually takes less time. Arthroscopic Latarjet takes longer, especially early in a surgeon's experience; operating time stabilises after roughly 30–50 cases.
When can I return to sport after a Latarjet?
Typically from about 4–6 months for contact and overhead sports, once strength, movement and confidence have returned and the bone block has healed.
What are the main risks?
Recurrent instability, loss of rotation, graft non-union or resorption, screw problems, nerve injury, infection and, in the long term, arthritis – similar for both techniques in experienced hands.
Why is arthroscopic Latarjet more expensive?
It requires specialised instruments and implants, and usually a longer operating time.
Do I need a Latarjet or a Bankart repair?
It depends on bone loss, the number of dislocations, your sport and age. With significant bone loss or high-risk sport, the Latarjet has lower recurrence than a Bankart repair.
References
- Deng Z, et al. Open versus arthroscopic Latarjet for recurrent anterior shoulder instability: a systematic review and meta-analysis.
- Vuletić F, Bøe B. Current trends and outcomes for open vs. arthroscopic Latarjet. Current Reviews in Musculoskeletal Medicine, 2024.
- Ali J, et al. Open versus arthroscopic Latarjet procedure for chronic anterior glenohumeral instability with glenoid bone loss. Arthroscopy, 2020.
- Holovakha ML, et al. Comparative analysis of the open and the arthroscopic Latarjet procedure. Zaporozhye Medical Journal, 2020.
- Cerciello S, et al. Early outcomes and perioperative complications of the arthroscopic Latarjet procedure: systematic review and meta-analysis, 2019.
- Learning curve of arthroscopic Latarjet over the first 30 cases.
- The arthroscopic Latarjet: a multisurgeon learning curve analysis. Journal of Shoulder and Elbow Surgery.
- Bøe B, et al. Learning curve for arthroscopic shoulder Latarjet.
- Arthroscopic Latarjet: indications, techniques, and results.
- Arthroscopic Bankart repair versus open Latarjet: systematic review and meta-analysis, 2025.
- Mullett H. Scope vs open Latarjet. AANA Annual Meeting, 2019.
Disclaimer: This article is for educational purposes only and does not replace a consultation with a qualified shoulder surgeon.