Complications Following Anterior Shoulder Instability Treatment: Bankart Repair Versus Latarjet

Abstract

The purpose of this study was to utilize a large population cohort to compare complication and reoperation rates following the Latarjet procedure to those following arthroscopic Bankart repair. Using current procedural terminology codes, a population database was used to generate a cohort of patients who underwent Latarjet and Bankart repair between 2007-2014 in the United States. Complications following surgery were identified using ICD9 codes, including deep vein thrombosis/pulmonary embolus (DVT/PE), nerve injury, surgical site infection (SSI), hematoma, capsulitis, and dislocation, while CPT codes were used to determine overall and procedure specific reoperations, including irrigation and debridement (I&D), open reduction, and lysis of adhesions/manipulation under anesthesia. 5331 patients who underwent shoulder stabilization procedures between 2007 and 2014 were included. 4764 patients underwent arthroscopic Bankart repair (71.6% male), 428 patients underwent open Bankart repair (68.7% male), and 139 patients underwent Latarjet (75.5% male). There were significant increases in the annual rates of both arthroscopic Bankart repair (2007: 9.4% vs. 2014: 15.8%, P<0.001) and Latarjet (2007: <7.91% to 20.9%, P=0.016), while the number of open Bankart repairs decreased (2007: 16.8% vs 2014: 11.4%, P=0.002). The odds of reoperation at 90-days, 6-months, and 1-year following the Latarjet procedure was 350%, 210%, and 250% greater than arthroscopic Bankart repair, respectively (p<0.001 for all). The odds of a DVT/PE diagnosis (OR 8.2, p=0.02) were significantly greater following Latarjet versus arthroscopic Bankart repair. The odds of a postoperative SSI, nerve injury, adhesive capsulitis, or I&D were not significantly different between patients undergoing Latarjet and arthroscopic Bankart repair. The rate of utilization of Latarjet and arthroscopic Bankart repair has increased in the past seven years, while the rate of open stabilization has decreased. The odds of requiring a reoperation or developing any complication were greater following Latarjet versus arthroscopic Bankart repair.