Latarjet Coracoid Process Transfer

Latarjet Coracoid Process Transfer

Phase I (Weeks 0-4)

  1. Sling to be worn at all times except for showering and rehab under guidance of PT
  2. Range of Motion – True Passive Range of Motion Only to Patient ToleranceGoals: 140° Forward Flexion, 25° External Rotation in the 30° abducted position, 60-80° Abduction in the plane of the scapula without rotation, Limit Internal Rotation to 45° with the shoulder in the 30° abducted positionMaintain elbow at or anterior to mid-axillary line when patient is supine
  3. Goals: 140° Forward Flexion, 25° External Rotation in the 30° abducted position, 60-80° Abduction in the plane of the scapula without rotation, Limit Internal Rotation to 45° with the shoulder in the 30° abducted position
  4. Maintain elbow at or anterior to mid-axillary line when patient is supine
  5. Therapeutic Exercise – No canes or pulleys during this phaseCodman Exercies/PendulumsElbow/Wrist/Hand Range of Motion and Grip StrengtheningIsometric Scapular Stabilization
  6. Codman Exercies/Pendulums
  7. Elbow/Wrist/Hand Range of Motion and Grip Strengthening
  8. Isometric Scapular Stabilization
  9. Heat/Ice before and after PT sessions 

Phase II (Weeks 4-10)

  1. Discontinue sling immobilization at 6 weeks post-op
  2. Range of Motion4-6 weeks: PROM -> FF and Abduction to tolerance, 45° External Rotation in the 30° abducted position6-10 weeks: Begin AAROM -> AROM as tolerated: ER/IR to toleranceGoals: FF/Abduction > 155⁰, ER/IR >75⁰ at 90⁰ of shoulder abduction
  3. 4-6 weeks: PROM -> FF and Abduction to tolerance, 45° External Rotation in the 30° abducted position
  4. 6-10 weeks: Begin AAROM -> AROM as tolerated: ER/IR to toleranceGoals: FF/Abduction > 155⁰, ER/IR >75⁰ at 90⁰ of shoulder abduction
  5. Goals: FF/Abduction > 155⁰, ER/IR >75⁰ at 90⁰ of shoulder abduction
  6. Therapeutic Exercise4-6 weeks: Being gentle AAROM exercises (supine position), gentle joint mobilizations (grades I and II), continue with Phase I exercises6-10 weeks: Progress to active exercises with resistance, shoulder flexion with trunk flexed to 45° in upright position, begin deltoid and biceps strengthening,
  7. 4-6 weeks: Being gentle AAROM exercises (supine position), gentle joint mobilizations (grades I and II), continue with Phase I exercises
  8. 6-10 weeks: Progress to active exercises with resistance, shoulder flexion with trunk flexed to 45° in upright position, begin deltoid and biceps strengthening,
  9. Modalities per PT discretion

 Phase III (Weeks 10-16)

  1. Range of Motion – Progress to full AROM without discomfort
  2. Therapeutic ExerciseContinue with scapular strengtheningContinue and progress with Phase II exercisesBegin Internal/External Rotation IsometricsPush up plus (wall, counter, knees on floor, floor)
  3. Continue with scapular strengthening
  4. Continue and progress with Phase II exercises
  5. Begin Internal/External Rotation Isometrics
  6. Push up plus (wall, counter, knees on floor, floor)
  7. Modalities per PT discretion

 Phase IV (Months 4-6)

  1. Range of Motion – Full without discomfort
  2. Therapeutic Exercise – Advance strengthening as tolerated: isometrics -> therabands -> light weights8-12 repetitions/2-3 sets for Rotator Cuff, Deltoid and Scapular StabilizersReturn to sports at 6 months if approved
  3. 8-12 repetitions/2-3 sets for Rotator Cuff, Deltoid and Scapular Stabilizers
  4. Return to sports at 6 months if approved
  5. Modalities per PT discretion