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

Abstract

Introduction Arthroscopic Latarjet procedure indicated for anterior shoulder instability is currently an innovative surgery. The aim of this study was to analyse learning curve and short term complications after arthroscopic guided Latarjet procedure with double button fixation. Materials and methods Eighty-eight patients were included in a prospective study. Operative time, intraoperative and postoperative complications were recorded. Clinical evaluation was performed at 3,6 and 12 months. Radiographic assessment was based on immediate and 3 months postoperative CT-scan analysis. Results The mean operative time of 107 min (62–192 ± 30) significantly decrease with surgical experience (p > 0.0001; r: −0.8426, 95% CI [−0.9074 to −0.7384]). The rate of unexpected events or intraoperative complications was 3.3%: 1 conversion to open surgery, 1 coracoid fracture and 1 instrumentation problem. The rate of postoperative complication was 6.8%: 4 early migrations of coracoid transfer and 2 subluxations. These complications occurred before the tenth case. The coracoid was flush to the glenoid rim in 81% of cases. The rate of healing at 3 months significantly improved from 43% for the first 10 cases to 90% above 20 cases (p = 0.01). At mean follow-up of 9.6 months (3–24), the mean Walch–Duplay and Rowe score were 80 ± 12 and 81 ± 13 points respectively. Conclusion After this first experience, the rate of complication of arthroscopic Latarjet with double button fixation remained low (occurring during the 10 first cases) and short term clinical outcomes were promising. Operative time, position of the bone block and the rate of healing improved with surgical experience.