A national rugby player who had dislocated his shoulder more than 100 times underwent a rare surgery at Health City Cayman Islands to repair the joint.

Edward Westin, a member of the Cayman Islands’ national rugby team, has been on the road to recovery since March when his shoulder was repaired in a procedure performed by Dr. Alwin Almeida, the chief orthopedic surgeon and joint replacement specialist at Health City.

Mr. Westin underwent an advanced arthroscopic surgery called a Latarjet – a procedure that is considered minimally invasive. Dr. Almeida said in a statement that the surgery is rarely performed in North and South America.

“They do Latarjets in the U.S., but arthroscopic Latarjet is less common,” said Dr. Almeida. “The technique that we used was a special technique, which was [first] described by Dr. Pascal Boileau [from France]. This is probably the first time it has been done in the [Caribbean and Latin American] region.”

The Latarjet procedure, first described by French surgeon Dr. Michel Latarjet in 1954, is used to treat recurring shoulder dislocations typically caused by bone loss or a fracture of the glenoid. Performing the surgery arthroscopically, though, is still a very rare procedure around the world.

Dr. Almeida examined Mr. Westin and considered him a good candidate for the surgery. Mr. Westin had previously had surgery on his left shoulder, but it did not stop the chronic dislocations from occurring. Then, after meeting Dr. Almeida in 2017, he began to believe that his shoulder could be healed.

“[Dr. Almeida] actually goes to the same church as me, and so I explained … my injuries,” he said. “I have dislocated my shoulders multiple times over the last few years, and he said whenever I have a break in my playing just to get a hold of him and come down to Health City and get them checked out.”

The shoulder is the most unstable joint in the body, and more than 90 percent of the body’s dislocations are related to the shoulder. Once a shoulder has been dislocated, there is a 40 to 50 percent it can dislocate again. And for Mr. Westin, dislocations could occur even while he was sleeping.

Dr. Almeida studied Mr. Westin’s medical history before recommending the Latarjet procedure.

“I studied the images and the surgery that was done on the left side and we realized he had undergone a surgery known as arthroscopic Bankart surgery,” said Dr. Almeida of Mr. Westin’s previous operation. “But the problem with him was really the bone loss. His glenoid socket was so small, and to add to that, the added bone loss that he had made it even smaller. So he had a very unstable shoulder.”

The surgery, said Dr. Almeida, works to combat the added bone loss.

“We take the coracoid process with the attached tendons to it and we transfer this,” he said.

“We saw it off and we transfer this coracoid to the glenoid base, because this glenoid socket has lost bone in the front, and we put this coracoid bone at that point. That gives the stability and makes up for the bone loss, and it gives added stability from the ligaments and the tendons attached to it.”

Mr. Westin has not ruled out a return to competitive rugby at some point in the future. For now, he’s just trying to get healthy again.

“That’s the plan right now,” said Mr. Westin. “I still want to get back on the field, but I guess I have to assess after that year of recovery [and] make sure I’m ready for it, first of all.”

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