Danilkowicz Richard M, Crook Bryan, Kim Jaewhan, Robinette Jesse Patton, O'Donnell Jeffrey, Grimm Nathan L
Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina, USA.
Department of Physical Therapy, University of Utah College of Health, Salt Lake City, Utah, USA.
Orthop J Sports Med. 2022 Feb 18;10(2):23259671211062573. doi: 10.1177/23259671211062573. eCollection 2022 Feb.
The open Latarjet has become the most common method of addressing significant glenoid bone loss in patients with recurrent glenohumeral instability.
To describe national trends in Latarjet procedures and risk factors for complications associated with this procedure.
Cohort study; Level of evidence, 3.
Eligible patients were identified through the National Surgical Quality Improvement Program (NSQIP) data set over the years 2014 to 2018 by using the Current Procedural Terminology (CPT) code for "capsulorrhaphy anterior with coracoid process transfer" (CPT 23462). Patient and surgical outcome variables were extracted and analyzed from the NSQIP database. Logistic regression analysis and odds ratios (ORs) were performed to evaluate the relative risk of complications.
The authors identified 458 patients (399 men and 59 women) from the data set. The mean body mass index was 27.4 kg/m, and mean operative time was 130.2 minutes. Statistically significant variables included smoking status and sex, which were further stratified. Smokers were 2.19 times more likely to experience at least 1 adverse outcome, including deep vein thrombosis (DVT), pulmonary embolism, reoperation, wound infection, unplanned readmission, or readmission (95% CI, 0.62-7.82). Specifically, smokers were 7.8 times more likely to have a DVT (95% CI, 0.58-105.96), 1.4 times more likely to undergo reoperation (95% CI, 0.14-5.73), and 2.4 times more likely to have an unplanned readmission (95% CI, 0.19-28.68). Women were 2.2 times more likely to experience at least 1 adverse outcome. Specifically, women were found to be 6.4 times more likely to have a DVT (95% CI, 0.76-54.87), 4.1 times more likely to have an unplanned readmission (95% CI, 0.00-106.21), and 4.7 times more likely to have a readmission (95% CI, 0.00-13.92).
The results indicate that smokers and female patients are at a higher risk of experiencing adverse outcomes and may require additional pre- and postprocedural precautions when undergoing the Latarjet procedure. With the increase in frequency, providers should be aware of patient-related factors that may lead to adverse outcomes.
开放式Latarjet手术已成为治疗复发性盂肱关节不稳且伴有明显肩胛盂骨质流失患者的最常用方法。
描述Latarjet手术的全国趋势以及该手术相关并发症的危险因素。
队列研究；证据等级为3级。
通过使用“带喙突转移的前路关节囊缝合术”（现行手术操作术语[CPT]编码23462），从2014年至2018年的国家外科质量改进计划（NSQIP）数据集中确定符合条件的患者。从NSQIP数据库中提取并分析患者和手术结果变量。进行逻辑回归分析和比值比（OR）计算以评估并发症的相对风险。
作者从数据集中识别出458例患者（399例男性和59例女性）。平均体重指数为27.4kg/m²，平均手术时间为130.2分钟。具有统计学意义的变量包括吸烟状况和性别，并对其进行了进一步分层。吸烟者发生至少1种不良结局的可能性是不吸烟者的2.19倍，这些不良结局包括深静脉血栓形成（DVT）、肺栓塞、再次手术、伤口感染、计划外再入院或再入院（95%CI，0.62 - 7.82）。具体而言，吸烟者发生DVT的可能性是不吸烟者的7.8倍（95%CI，0.58 - 105.96），再次手术的可能性是不吸烟者的1.4倍（95%CI，0.14 - 5.73），计划外再入院的可能性是不吸烟者的2.4倍（95%CI，0.19 - 28.68）。女性发生至少1种不良结局的可能性是男性的2.2倍。具体而言，女性发生DVT的可能性是男性的6.4倍（95%CI，0.76 - 54.87），计划外再入院的可能性是男性的4.1倍（95%CI，0.00 - 106.21），再入院的可能性是男性的4.7倍（95%CI，0.00 - 13.92）。
结果表明，吸烟者和女性患者发生不良结局的风险较高，在接受Latarjet手术时可能需要额外的术前和术后预防措施。随着手术频率的增加，医疗服务提供者应了解可能导致不良结局的患者相关因素。
