A 29-year-old man, who was a medical intern presented with history of recurrent shoulder dislocation. Radiographs
and computed tomography imaging revealed a bony bankart lesion with glenoid bone loss of 25% with moderate
Hill- Sachs lesion. Latarjet surgery was performed. At post-operative 8 months, the patient experienced pain and
clicking in the left shoulder while performing cardiopulmonary resuscitation. At post-operative 1 year, magnetic resonance arthrography showed a united coracoid graft and intact posterior labrum. Left shoulder diagnostic arthroscopy and removal of Latarjet screws through a limited anterior deltopectoral approach were performed. The symptoms
pain, clicking and instability sense was caused by either the prominent distal screw or the remnant suture material
from the anchor which resulted in impingement of the infraspinatus muscle. We recommend the use of image intensifier to check on the position and length of the screw at the end of the surgery to avoid this complication
Combined latissimus dorsi transfer, subscapularis repair and Latarjet surgery is rare and has never been reported. A 35-year-old man with chronic shoulder pain had a long history of instability of his right shoulder. The first episode occurred during a game of touch rugby followed by multiple episodes of subluxation. MRI was done which showed complete tear of the subscapularis anteriorly which was retracted and atrophied indicating a longstanding tear. There was also significant mid substance supraspinatus tendon tear. Patient then underwent two surgeries. The initial sur- gery found the rotator cuff to be irreparable with glenoid bone loss and only acromioplasty with acromioclavicular joint resection were performed. He then had a single stage surgery consisting of latissimus dorsi transfer, Latarjet procedure and subscapularis repair. A two-stage surgery can be avoided, and good results can be obtained provided that the patient undergo correct rehabilitation regime after undergoing a single stage surgery.