Utilization of a stepwise model to assess pivotal information for patient decision-making regarding open vs. arthroscopic Latarjet procedure.

Autor: Cochard B; Division of Orthopaedics and Trauma Surgery, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland. Electronic address: blaise.cochard@hcuge.ch., Lädermann A; Division of Orthopaedics and Trauma Surgery, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland; Division of Orthopaedics and Trauma Surgery, La Tour Hospital, Meyrin, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland; FORE (Foundation for Research and Teaching in Orthopedics, Sports Medicine, Trauma, and Imaging in the Musculoskeletal System), Meyrin, Switzerland., Bonnevialle N; Department of Orthopaedic Surgery, Hôpital Pierre-Paul Riquet, Toulouse, France., Collin P; Division of Orthopaedics and Trauma Surgery, CHP Saint-Gregoire, Saint-Grégoire, France; Clinique Victor Hugo, Paris, France; American Hospital of Paris, Neuilly-sur-Seine, France., Chong XL; Division of Orthopaedics and Trauma Surgery, Royal Square Medical Center, Singapore., Bothorel H; Research Department, La Tour Hospital, Meyrin, Switzerland., Ho SWL; Department of Orthopaedic Surgery, Tan Tock Seng Hospital, Singapore.
Jazyk: angličtina
Zdroj: Journal of shoulder and elbow surgery [J Shoulder Elbow Surg] 2024 Dec; Vol. 33 (12), pp. 2834-2841. Date of Electronic Publication: 2024 Jul 30.
DOI: 10.1016/j.jse.2024.05.053
Abstrakt: Background: The popularity of arthroscopic Latarjet has increased significantly in recent years due to its perceived advantages. The latter include a smaller surgical incision, faster recovery, quicker return to sports, and ability to treat concomitant intra-articular pathology. Nevertheless, the arthroscopic technique is more technically challenging, has a more significant learning curve, longer operating time, and is less cost-effective. The study aimed to identify the various factors influencing patient decision-making between undergoing arthroscopic or open Latarjet using a stepwise questionnaire model.
Methods: All patients with a primary, whether arthroscopic or open Latarjet procedure were subjected to a stepwise interviewing process and were asked to select between arthroscopic and open approaches at each step.
Results: Fifty patients with a mean age of 28.8 ± 8.8 year old participated in the study. Twenty (40%) consistently selected an arthroscopic approach after analysis of the incision's aspect, whereas 34 (68%) had a final decision different from their initial choice. In addition, out of the 15 patients who chose arthroscopy or were undetermined after presentation of the incisional aspect, 9 (60%) changed their decision to open surgery after presentation of the pros and cons of each approach. Twenty-three (46%) patients were unable to choose and left the choice to their surgeon. The faith in their surgeon and recovery were identified as the 2 most important factors influencing patients' final decisions.
Conclusions: The minimally invasive nature of arthroscopic incisions was not considered to be more cosmetically appealing than that of a single open incision. The advantages of the arthroscopic procedure may not be as valued by patients as by surgeons. Patients were more interested in the equivalent short- and mid-term outcomes of both approaches and the shorter surgical duration of the open option. It is crucial to adequately inform patients during preoperative counseling to achieve the best consensus.
(Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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