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Arthroscopic Latarjet procedure with double-button fixation: short-term complications and learning curve analysis

Abstract : BACKGROUND: The arthroscopic Latarjet with double-button fixation is a guided procedure recently proposed to treat anterior shoulder instability with glenoid bone loss. The goal of this study was to report intraoperative and early postoperative complications and to analyze the learning curve. METHODS: This was a prospective, nonrandomized study that included 88 patients. Intraoperative or postoperative complications as well as adverse events and operative time were recorded. Clinical outcomes were evaluated at 2 weeks, 1.5 months, and at the last follow-up. Radiologic analysis was based on an immediate postoperative computed tomography scan. RESULTS: The intraoperative complications or adverse events rate was 3.3%: 1 conversion to open surgery, 1 bone block fracture, and 1 instrumentation problem. The postoperative complication rate was 6.8%: 4 coracoid migrations, and 2 subluxations. None of these complications occurred beyond the 10th case performed. The average operative time significantly decreased with surgical experience (r = -0.8426; 95% confidence interval, -0.9074 to -0.7384; P < .0001) to reach 76 ± 12 minutes (range, 62-95 minutes) at 30 cases. Radiologically, 90% of the bone blocks were flush and subequatorial beyond the 30th case. At a mean follow-up of 12.6 months (range, 6-24 months), Walch-Duplay and Rowe scores were 80 and 81 points, respectively. CONCLUSIONS: At short-term follow-up, the arthroscopic Latarjet procedure with double-button fixation exhibited a low complication rate. Operative time significantly improved with surgical experience and was optimized after 30 cases. Early clinical results confirmed that this procedure can be safe and reliable.
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Submitted on : Tuesday, May 21, 2019 - 9:22:02 AM
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Nicolas Bonnevialle, Charles Edouard Thélu, Yves Bouju, Jérôme Vogels, Charles Agout, et al.. Arthroscopic Latarjet procedure with double-button fixation: short-term complications and learning curve analysis. Journal of Shoulder and Elbow Surgery, Elsevier, 2018, 27 (6), pp.e189-e195. ⟨10.1016/j.jse.2017.12.007⟩. ⟨hal-02135117⟩

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