Learning Curves in the Arthroscopic Latarjet Procedure: A Multicenter Analysis of the First 25 Cases of 5 International Surgeons
| Autor: | Roman Brzóska, Laurent Lafosse, Gilles Walch, Jan Leuzinger, Pierre Metais, Philippe Clavert, Daniel Smolen, Geoffroy Nourissat |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Joint Instability Male Reoperation medicine.medical_specialty Adolescent Operative Time Arthroplasty Arthroscopy Young Adult 03 medical and health sciences Surgical time Postoperative Complications 0302 clinical medicine Humans Medicine Orthopedics and Sports Medicine Recurrent instability Retrospective Studies Surgeons 030222 orthopedics Shoulder Joint business.industry Shoulder Dislocation Level iv Retrospective cohort study 030229 sport sciences Anterior shoulder Middle Aged Latarjet procedure Surgery Scapula Operative time Female Tomography X-Ray Computed business Complication Learning Curve |
| Zdroj: | Arthroscopy: The Journal of Arthroscopic & Related Surgery. 35:2304-2311 |
| ISSN: | 0749-8063 |
| Popis: | To analyze the learning curves of 5 experienced, fellowship-trained shoulder surgeons and their respective 25 first arthroscopic Latarjet cases in regard to surgical time, graft placement, complication rates, and recurrent instability.The first 25 arthroscopic Latarjet procedures of 5 surgeons were retrospectively analyzed in an international multicenter setting, and thus 125 patients were included in this study. The surgical time, intraoperative and postoperative events out of the ordinary, and graft positioning were examined.The 125 patients consisted of 16 women (12.8%) and 109 men (87.2%). In 81.6% (n = 102), surgery was undertaken as a first-line procedure, whereas 18.4% (n = 23) were revisions. Surgical time decreased significantly from an average of 123.8 minutes (range 70 to 210) to 92.6 minutes (range 50 to 160) from the first 5 cases to the last 5 cases of each surgeon within a period of2 years. Overall, 22 events in 21 patients requiring additional treatment were reported (17.6%). Five (4%) were unlikely to affect final outcome and did not require revision surgery. Twelve (9.6%) required revision surgery that was not trauma related yet was prone to affect outcomes. Five events were trauma-related (4%), 4 requiring revision surgery and 1 treated conservatively. Overall, 6 patients (4.8%) had recurrent shoulder instability, 3 as a result of a traumatic event. Conventional radiology showed the bone-block in ideal positioning in 93 cases (74.4%), flush with the glenoid in a true anteroposterior view. In 3 cases (2.4%), it was considered too high, 15 too low (12%), 5 too lateral (4%), and 15 too medial (12%). Some patients had combinations of the above.This analysis shows that surgical time in arthroscopic Latarjet can be significantly reduced after only 20 cases. However, complication rates did not decrease over this time. The authors believe that the arthroscopic Latarjet is a challenging yet viable technique to treat anterior shoulder instability, achieving results equal to the open technique with advantages of the arthroscopic setting.Level IV, retrospective cohort study. |
| Databáze: | OpenAIRE |
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