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Arthroscopic Latarjet procedure with double-button fixation: short-term complications and learning curve analysis
Nicolas Bonnevialle1, Charles Edouard Thélu2, Yves Bouju3
1Département d'Orthopédie Traumatologie du Centre Hospitalier Universitaire de Toulouse, Hôpital Riquet, Toulouse, France; Laboratoire de Biomécanique, Institut de Mécanique des Fluides de Toulouse- Unité Mixte de Recherche-Le Centre national de la recherche scientifique 5502, Hôpital Riquet, Toulouse, France.
Journal of Shoulder and Elbow Surgery
|January 17, 2018
Summary
The arthroscopic Latarjet procedure with double-button fixation shows a low complication rate for shoulder instability. Surgical time improves with experience, becoming optimal after 30 cases, indicating a safe and reliable treatment.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Arthroscopic Techniques
Background:
- Anterior shoulder instability with glenoid bone loss is a significant clinical challenge.
- The arthroscopic Latarjet procedure with double-button fixation is an emerging technique for managing this condition.
- Understanding its complication profile and learning curve is crucial for widespread adoption.
Purpose of the Study:
- To evaluate intraoperative and early postoperative complications of the arthroscopic Latarjet procedure.
- To analyze the learning curve associated with this surgical technique.
- To assess early clinical outcomes and radiologic results.
Main Methods:
- Prospective, nonrandomized study of 88 patients undergoing arthroscopic Latarjet with double-button fixation.
- Systematic recording of intraoperative/postoperative complications, adverse events, and operative times.
- Clinical evaluation at 2 weeks, 1.5 months, and final follow-up; radiologic assessment via CT scan.
Main Results:
- Low intraoperative complication rate (3.3%) and postoperative complication rate (6.8%).
- No complications occurred after the 10th case, indicating a learning curve.
- Significant decrease in operative time with experience, stabilizing after 30 cases.
- High rate of well-positioned bone blocks (90% flush/subequatorial post-30 cases).
- Favorable clinical outcomes with high Walch-Duplay (80) and Rowe (81) scores at mean 12.6-month follow-up.
Conclusions:
- The arthroscopic Latarjet procedure with double-button fixation demonstrates a low complication rate in the short term.
- Surgical proficiency and operative time improve significantly with experience, optimizing after approximately 30 cases.
- Early clinical results suggest the procedure is both safe and reliable for treating anterior shoulder instability with bone loss.
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