Speaker: Anticipate risks, perioperative complications in shoulder instability repair
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TAMPA, Fla. — An evaluation of perioperative outcomes in patients who underwent shoulder stabilization surgery revealed a high incidence of serious complications with the Latarjet-Bristow approach, according to a presenter.
“There are multiple factors that can influence the surgical approach [for shoulder instability]. Specifically, previous literature has reported decreased stability and/or poor outcomes for patients with glenoid bone loss, ranging from 13.5% to 30%,” Christopher T. Eberlin, BS, said in his presentation at the Orthopaedic Research Society Annual Meeting.
Due to the array of surgical indications for intermediate glenoid bone loss, which can make operative decision-making difficult, Eberlin and colleagues aimed to analyze surgical risks and perioperative complications associated with three different shoulder stabilizations.
Using National Surgical Quality Improvement Program data from 2007 to 2019, Eberlin and colleagues compared outcomes of 9,128 patients who underwent arthroscopic Bankart, 1,148 patients who underwent open Bankart and 679 patients who underwent Latarjet-Bristow procedures. Outcome measures included 30-day complication rates, readmissions and operative time. Researchers also analyzed utilizations trends, according to the abstract.
Surgical outcomes
Among all three cohorts, the Latarjet-Bristow cohort had the highest odds of serious complications, reoperation, readmission and wound complications. Compared with the arthroscopic Bankart cohort, patients who underwent a Latarjet-Bristow procedure had longer operative times (129.96 minutes vs. 86 minutes), increased serious complications (2.5% vs. 0.4%), reoperations (1.9% vs. 0.1%), readmissions (1.8% vs. 0.3%), thromboembolic complications (0.4% vs. 0.1%) and sepsis (0.4% vs. 0.0%), Eberlin noted. Additionally, researchers found patients in the open Bankart cohort had longer operative times and an increased incidence of sepsis compared with the arthroscopic Bankart cohort.
Utilization trends
After studying utilization trends from 2011 to 2013 and 2017 to 2019, Eberlin and colleagues found relative utilization increased from 83.4% to 91.2% in the arthroscopic Bankart cohort, while utilization decreased from 16.6% to 8.8% in the open Bankart cohort.
“This study demonstrated that not only has the relatively utilization of arthroscopic Bankart increased over last decade, but it has always maintained a low adverse event rate,” Eberlin said.
“This study offers health care providers the most up-to-date and all-inclusive evaluation of the perioperative complications associated with the different stabilization procedures,” he concluded.
Collapse
Eberlin CT. Evaluation of perioperative complications and procedure trends in shoulder instability repair. Presented at: Orthopaedic Research Society Annual Meeting. Feb. 4-8, 2022; Tampa, Fla.
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