No Differences in 90-Day Complications and Admissions After Latarjet Procedure for Primary Bone Loss Versus Latarjet Procedure for Failed Arthroscopic Instability Repair

Neil Gambhir; Matthew G Alben; Matthew T Kim; Soterios Gyftopoulos; Andrew S Rokito; Mandeep S Virk

doi:10.1016/j.asmr.2022.06.010

No Differences in 90-Day Complications and Admissions After Latarjet Procedure for Primary Bone Loss Versus Latarjet Procedure for Failed Arthroscopic Instability Repair

Arthrosc Sports Med Rehabil. 2022 Aug 25;4(5):e1647-e1651. doi: 10.1016/j.asmr.2022.06.010. eCollection 2022 Oct.

Authors

Neil Gambhir¹, Matthew G Alben¹, Matthew T Kim¹, Soterios Gyftopoulos¹, Andrew S Rokito¹, Mandeep S Virk¹

Affiliation

¹ Division of Shoulder and Elbow Surgery, Department of Orthopaedic Surgery, NYU Langone Orthopedic Hospital-NYU Langone Health, New York, New York, U.S.A.

Abstract

Purpose: To investigate the variance in 90-day complication, emergency department (ED) visit, revision, and readmission rates between the Latarjet procedure (LP) performed as a primary procedure for the treatment of recurrent shoulder instability associated with critical levels of glenohumeral bone loss and the LP performed as a salvage surgical procedure after failed arthroscopic instability repair (FAIR).

Methods: Patients who underwent a primary LP from 2016-2021 in a single surgeon's practice were identified and divided into 2 cohorts based on the indication for surgery: primary LP for critical bone loss (unipolar or bipolar) (LP-PBL) or LP as salvage surgery for FAIR (LP-FAIR). Patients without a minimum follow-up period of 90 days were excluded. Chart review was conducted to analyze the prevalence of complications, ED visits and/or admissions, and secondary procedures in the 90-day postoperative period. Radiographic images were reviewed to evaluate for graft and/or hardware failure. An unpaired t test and the Fisher exact test were used to compare the 2 groups regarding continuous and categorical data, respectively, and the significance level was set at P < .05.

Results: The final sample sizes consisted of 54 patients in the LP-PBL group and 23 patients in the LP-FAIR group. In the postoperative period, 4 complications were observed in the first 90 days. These included complex regional pain syndrome (n = 1) and superficial wound dehiscence (n = 1) in the LP-PBL cohort. Superficial suture abscess (n = 1) and audible crepitation (n = 1) were observed in the LP-FAIR cohort. There was 1 secondary intervention (arthroscopic debridement) in the LP-FAIR cohort. No statistically significant difference in complication rates, ED visits or admissions, or secondary procedures was found between the LP-PBL and LP-FAIR groups.

Conclusions: The results of this study indicate that the 90-day complication, ED visit, revision, and readmission rates after open LP are low irrespective of the extent of glenoid or bipolar bone loss and history of arthroscopic instability repair.

Level of evidence: Level III, retrospective cohort study.