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      8 years Post Latarjet repair....now having issues.
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      TOPIC: 8 years Post Latarjet repair....now having issues.

      8 years Post Latarjet repair....now having issues. 2 years ago #31356

      • ToPHeR35
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      A little history: I've had 3 previous shoulder surgeries all on my right shoulder due to dislocations. I was a D1 baseball player so they were all caused by that sports. Each one was a labrum tear and the last repair in 2007 they also shaved down the head of the glenoid because it chipped when it was dislocated. I've had anchors and screws placed as well. The last surgery was in 2007 and I've never had a problem since until this past January.

      I am a very active 27/m who lifts weights and does cardio literally every day.

      It all started in January when I was doing a shoulder routine and I was doing triangle arm raises with light weight to work on my shoulder strength and stability. I was in between sets when I decided to stretch out my legs and get ready for cardio. I was swinging my leg with my arms fully extended against the dumbbell weight rack to hold myself in place when all of a sudden I felt a sharp, sudden weakness sensation in the armpit area. I immediately thought tear or worse yet another dislocation. I proceeded to do some arm raises and circular arm motions to make sure my shoulder was still in place, which it was. I ended my workout and went back home to ice right away.

      It was after the icing when I started feeling the pain. I loss alot of ROM and the shoulder felt weak to the point where I had to hold it at my side in place because any free movement hurt. Doing anything like reaching out or bending down to get something hurt. Also, getting in the car and my shoulder pushing against the backrest would hurt, but I knew it wasn't out of place because I could raise my arm straight up and to the side, just more gingerly.

      I went and saw my ortho who thought it was nothing so he sent me home with some corticosteroid and told me to do 4 weeks of PT. The entire 1st week the shoulder felt terrible. Walking with it down by my side or hand in coat pocket (like a chicken wing) felt very unstable. I started PT the 2nd week and the first day it was an eval for ROM. I remember being in a ton of pain that night because of all the tests they do for ROM. I figured this was normal because the PT said I would be sore. Things like reaching up to the microwave or reaching out to grab something hurt or I would hear lots of cracking.

      I did the 4 weeks and my ROM improved a ton, but my strength still wasn't there. I went back to the ortho for a follow up and he looked at the ROM and said everything was good. He did 3 tests: shoulder at 90 degree by my side. arm straight out in front, and arm straight in front but slightly raised like making a toast. I didn't feel any pain in any of those. He prescribed 6 more weeks of PT.

      Flash forward to now. I have finished the 6 weeks and my strength is still not there. The most I was able to do in 10 weeks of PT was the I,Y, & Ts with the theraband and holding a pushup position on a half stability ball for 30 seconds. The problem is both of these exercises produced pain which is as far as I got.

      With the I,Y, and Ts I would get a sudden, sharp pain in the anterior region which came on very strong. It's like the anterior region and also underneath in the armpit area. When it happens I have to stop and "re-adjust" my shoulder by rotating it int/external rotations until something feels like it goes back in place. Other times I will do the exercises at PT and then by the end of the day I get a ton of tightness in the armpit area as if something is tangled and has to unwind or the tension has to break free. Arm down by my side with thumb rotation inward, external rotations movement, and arm bent against my chest pushing against me all produce the pain and the further/harder I push/rotate the more intense the pain. The weird part is the next day the pain goes away and I can do the int/ext rotations with no pain, but the IYT always produce it and it lingers for the rest of the day and any other exercise is painful. It will happen in the middle of the exercise like an instantaneous trigger which I then have to let go and brace the shoulder.

      Other times I will get random sudden pain as if something is moving/adjusting in the posterior region like on the backside of the glenoid head. It's not lingering, it's instantaneous and kind of a shock when it happens and then it's done.

      The weird part is I can do most daily activities with little or no problem at all. It seems like when I do something too quickly or try to push my physical activity/ PT a little bit is when the problems starts acting up. It's like if I just sat on my butt all day or just went to work, came home, ate, and slept I would be fine.

      I told my PT about all of this and we agreed I need a 2nd opinion. She tried as many tests and she can and I have the most problems with subscap exercises, but my fear is there is more involved than just the subscap.My fear is something like a SLAP tear or biceps tendon issues. The PT pushed on the biceps area and I didn't react and she said most people with this problem would jump and want to punch her in the face with all the pain.

      I've been through 10 weeks of PT at this point and I believe I should be way further along than I am at this point. Like I said, I am a perfectly healthy 27/m who works out 7x a week and now my shoulder is preventing alot of this.

      Just looking to see if anyone has had any similar problems who could help me out as I am totally lost and confused at this point. It all started in the armpit area and now I'm afraid that it's also effecting the outside area around the glenoid capsule. I can't have an MRI because of my screws so I will probably have to do a CT scan or ultrasound which scares me because I know the MRI is the best option for diagnosis. The last thing I want to be is "that guy" with no diagnosis.

      Thank You!

      Re: 8 years Post Latarjet repair....now having issues. 1 year, 10 months ago #31425

      • ToPHeR35
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      *Update on my MRI/CT scans..


      -No tears found
      -biceps tendon in tact

      *-Evidence of a 0.8cm filling defect within the anterior joint space approx @ the 3o'clock position. Finding is suggestive of a lose body of indeterminate donor site and not excluding detached surgical bone fragment.

      Re: 8 years Post Latarjet repair....now having issues. 1 year, 10 months ago #31426

      • jnthn
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      So does the last line of your post suggest that there is possibly a fragment of the grafted coracoid giving you problems? Though it could be something else it seems, correct?

      I have been debating the Latarjet for about two years now and will most likely go ahead with it this winter. I am 9 years older than you but still very active so am curious how active people feel several years after the procedure. I do hope you are able to resolve it. Best of luck!

      Re: 8 years Post Latarjet repair....now having issues. 1 year, 10 months ago #31427

      • ToPHeR35
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      Thanks for the reply! I have nothing bad to say abut the surgery itself! The only issue is your labrum will be alot tighter so you will lose some ROM naturally, but I've never had any problems and I played a full season of baseball at a highly competitive D1 program a year after the surgery. My total recovery was 6 months. I still work out daily and didn't really have any restrictions. Just don't do things like behind the neck pulldowns or other exercises that they warn you about in typical labrum repairs. Also, since they reattach the subscap that can be kind of tricky at first too. I still workout constantly and I love water sports and wakeboard every summer. If falling on it from high in the air being pulled 20mph behind and boat doesn't make it dislocate, then I don't know what would...

      Basically, if you are contemplating the latarjet you really don't have a choice at this point. Either you get the surgery and get it tightened or you will just keep dislocating.

      As far as the MRI results, they don't know what it is. Could be bone could, be something else...who knows? (It actually took them 5 tries to get the dye in the labrum because it was so tightened) This is why my ortho suggested going in with the scope and checking it out, but he knows for sure that one big solid piece is there. I also get some catching occasionally in the rear too so maybe some there as well? I guess they won't know until they scope it. I knew something was still wrong even after my ortho who did the surgery said it was just a "fluke". I really noticed the problems doing the I,Y,&Ts therabands and it was like once that tripped the pain it would be constant on anything external rotation or inward hand rotation like something was catching and increasing the tension. It isn't as intense now, but then again I am no where near the same levels as I was pre-injury. I can still workout, just not at the same weight and I also have to do it in a very controlled motion. Nothing too free moving where my arms gets really extended because the pain comes back. Another thing that sets it off is driving. I drive with the same arm and I rest my elbow on the center console and control the wheel with that hand and I can feel the pain(so like elbow down and sort of tucked in with hand slight externally rotating.

      I'm just so mad because my original ortho kept telling me for months it was a fluke and I wasted 3 doctor visits on him and 10 weeks of PT which killed my insurance premium only to find out that it was not just a "fluke". Now I have some pain in the front of my good shoulder like right in the joint because I think it's from overuse all these months. (That started out with me sitting in a chair and reaching directly behind me to grab my phone and heard a loud CRACK followed by a dull, burning ache). Plus now my hip is getting bad (Hopefully now the labrum there!) So I'm just really in a bad place at the moment...

      I might hold off on the scope until August because I'm moving next month and kind of busy at work. Plus I want to see if some chiropractic adjustments will help the hip and other shoulder first...

      Re: 8 years Post Latarjet repair....now having issues. 1 year, 10 months ago #31430

      • ljansen
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      well you were right that something didn't feel right!! wonder where that fragment is coming from and no doubt that could be the cause of that intermittent pain. In terms of the attachments to the graft, it would likely be difficult to know if anything is of issue there without looking through a scope...just because it's so difficult to see on MRI/CT with everything being moved around from the latarjet. They can barely figure out what anything is under any MRIs i've had. everything comes back as it should look after a latarjet but then overtime I had surgery they always found something not right.
      R. Shoulder Capsular Shift - Sept. 03
      L. Shoulder Bankart/SLAP/Capsular Shift/Rotator interval & SS repair - Jan. 05
      L. Shoulder MUA/adhesion release - Jan. 06
      L. Shoulder SAD/Bursectomy - Sept. 07
      L. Shoulder Biceps Tenodesis - Mar. 09
      L. Shoulder Open Latarjet & Arthroscopy - Nov. 24, 2011
      L. Shoulder Capsular Release/SAD - June 11, 2012
      L. Shoulder Capsular Release/Screw Removal/Biceps Tenotomy - Mar. 22, 2013
      L. Shoulder Arthroscopic Latarjet Screw Removal, Interval Repair, Axillary Neurolysis, Debridement

      Re: 8 years Post Latarjet repair....now having issues. 1 year, 10 months ago #31432

      • ToPHeR35
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      I agree. The area that showed up on the mri is definitely one of the areas where the pain is coming from. My concern is I also feel catching in the back of the shoulder as well like in the rear of the glenoid but the mri only showed a fragment in the 3 o'clock which is the front. Hopefully they can see better with the scope when they go in. We talked about the procedure and he said maybe late July, but I'm moving around then so I might put it off until August. My other major concern is my hip on the same side has been severely sore since Memorial day and I'm having pain just walking. I'm scared I might have torn that labrum now so I will probably have to get that mried. I'm also dealing with what I think is sphenoid sinusitis for the past 3 months and I get head pressure daily. Not a good year so far!
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