The arthroscopic Latarjet: a multisurgeon learning curve analysis.

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Surgical Innovation

Background:

• The open Latarjet procedure is a standard treatment for anterior shoulder instability.
• The arthroscopic Latarjet offers benefits but presents a steep learning curve.
• This study analyzes the learning curve for the arthroscopic Latarjet procedure across multiple surgeons.

Purpose of the Study:

• To evaluate the learning curve for the arthroscopic Latarjet procedure.
• To determine the number of cases required for surgical proficiency.
• To assess the impact of surgical volume on outcomes and complications.

Main Methods:

• Retrospective review of 573 patients across 12 surgeons in 5 countries.
• Analysis of operative time, CT bone-block positioning, complications, and patient-reported outcome measures (PROMs).
• Segmented linear regression modeling used for learning curve analysis.

Main Results:

• Operative time reached a steady state after 30-50 cases for high-volume surgeons.
• Bone-block positioning accuracy continuously improved without plateauing after 53 cases.
• No significant changes in PROMs or complication rates were observed with increased operative volume.

Conclusions:

• Specialist shoulder surgeons require 30-50 arthroscopic Latarjet procedures for steady-state operative efficiency and improved bone-block positioning.
• The arthroscopic Latarjet procedure should primarily be considered by surgeons intending to perform it in high volume.
• This learning curve analysis provides benchmarks for adopting the arthroscopic Latarjet procedure.