No difference in 90-day complication rate following open versus arthroscopic Latarjet procedure
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SHOULDER
No difference in 90‑day complication rate following open versus arthroscopic Latarjet procedure Eoghan T. Hurley1 · Amit K. Manjunath1 · Bogdan A. Matache1 · Nathan W. Jia1 · Mandeep Virk1 · Laith M. Jazrawi1 · Robert J. Meislin1 Received: 30 June 2020 / Accepted: 21 September 2020 © European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2020
Abstract The purpose of this study was to compare the 90-day complication rate between the open and arthroscopic Latarjet procedure. A retrospective review of patients who underwent an open or arthroscopic Latarjet procedure at NYU Langone Health between 2012 and 2019 was performed. The complications, readmissions, and reoperations within 90 days were assessed. Outcomes were compared between the two approaches, and a p value of 16 at the time of surgery, skeletal maturity, and a minimum follow-up of 90 days. All of the patients performed via the arthroscopic approach including the initial patients were included; no patients were excluded as part of the learning curve. Patients with a prior anterior bone-grafting procedure or incomplete follow-up were excluded.
Knee Surgery, Sports Traumatology, Arthroscopy
Arthroscopic Latarjet The arthroscopic Latarjet was also performed under general anesthesia and an interscalene nerve block in the beach chair position with the addition of an arm positioner (Spider2, Smith & Nephew, Andover, MA, USA). The surgical technique follows the steps outlined by Lafosse et al. and modified by the senior surgeon. Six portals are utilized for this technique, which, in summary, consists of the following surgical steps: (1) preparation of the anterior glenoid neck; (2) rotator interval release; (3) anterior, superior, and posterior subscapularis release; (4) exposure of the coracoid and conjoint tendon; (5) subdeltoid bursoscopic CA ligament and pectoralis minor release; (6) coracoid osteotomy and graft preparation; (7) subscapularis split; (8) graft fixation using two 3.5-mm partially threaded, cannulated cancellous screws.
Data collection
Surgical technique
Data on patient characteristics and pre-operative demographics were collected; including age, gender, laterality, body mass index, previous shoulder surgeries, and ASA grade. Intra-operative and post-operative complications including recurrence, graft complications (including graft fracture or non-union), hardware complications, wound infections (deep or superficial), hematoma, and neurological complications. Additionally, readmissions and subsequent procedures performed within 90 days were recorded.
Open Latarjet
Statistical analysis
All patients underwent surgery in a beach chair position using a combination of general anesthesia and an interscalene regional nerve block. The surgical technique was standardized across all surgeons. In brief, an anterior incision was used to access the shoulder via a deltopectoral approach. The coracoid was exposed, the coracoacromial (CA) ligament was released 1 cm lateral to its insertion, and the pectoralis minor was pe
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