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 Tolerance
   • 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
   • Maintain elbow at or anterior to mid-axillary line when patient is supine
3. Therapeutic Exercise
   • No canes or pulleys during this phase
   • Codman Exercises / Pendulums
   • Elbow/Wrist/Hand Range of Motion and Grip Strengthening
   • Isometric Scapular Stabilization
4. Heat/Ice before and after PT sessions

Phase II (Weeks 4-10)

1. Discontinue sling immobilization at 6 weeks post-op
2. Range of Motion
   • 4–6 weeks: PROM → Forward Flexion and Abduction to tolerance, 45° External Rotation in the 30° abducted position
   • 6–10 weeks: Begin AAROM → AROM as tolerated; ER/IR to tolerance
   • Goals: Forward Flexion / Abduction >155°, ER/IR >75° at 90° of shoulder abduction
3. Therapeutic Exercise
   • 4–6 weeks: Begin gentle AAROM exercises (supine position), gentle joint mobilizations (grades I and II), continue with Phase I exercises
   • 6–10 weeks: Progress to active exercises with resistance, shoulder flexion with trunk flexed to 45° in upright position, begin deltoid and biceps strengthening
4. Modalities per PT discretion

Phase III (Weeks 10-16)

1. Range of Motion – Progress to full AROM without discomfort
2. Therapeutic Exercise
   • Continue with scapular strengthening
   • Continue and progress with Phase II exercises
   • Begin Internal/External Rotation Isometrics
   • Push up plus (wall, counter, knees on floor, floor)
3. 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 weights
   • 8–12 repetitions / 2–3 sets for Rotator Cuff, Deltoid and Scapular Stabilizers
   • Return to sports at 6 months if approved
3. Modalities per PT discretion