Department of Orthopaedic Surgery, Virginia Commonwealth University, Richmond, Virginia, U.S.A.
Department of Orthopaedic Surgery, Virginia Commonwealth University, Richmond, Virginia, U.S.A..
Arthroscopy. 2024 Mar;40(3):692-698. doi: 10.1016/j.arthro.2023.07.028. Epub 2023 Jul 31.
To compare the 30-day outcomes, including length of stay, short-term complications, hospital readmission, all-cause reoperation, and death after arthroscopic Bankart (AB) and Latarjet.
Patients in the National Surgical Quality Improvement Program database who had undergone either AB or Latarjet-Bristow (LB) procedures for anterior shoulder instability from 2012 to 2018 were identified using Current Procedural Terminology codes. Nearest neighbor propensity score matching was used to address any potential demographic differences. The 30-day incidence of postoperative complications were compared, and univariate and multivariate logistic regressions were used to identify risk factors associated with the incidence of post-operative complications.
A total of 7,519 patients were identified, with 6,990 (93.0%) undergoing AB and 529 (7.0%) LB. After propensity score matching, the baseline demographics were not significantly different (P > .05). There was no significant difference in rate of total adverse events between the AB and LB cohorts (P = .06). There was a significant difference in the rate of return to the operating room between LB (1.9%) when compared to AB (0%) (P < .001). Of reoperations, 40% were due to need for revision stabilization (0.8% of all LB cases) and 40% were for irrigation and debridement. There was also a significant difference in operative time (AB = 87 minutes, LB = 131 minutes; P < .0001).
Overall 30-day complication rates were low for both groups, with similar rates among AB and LB patients. However, there was a statistically significant increased rate of short-term reoperation or revision stabilization in the LB cohort.
Level III, retrospective comparative prognostic trial.
比较关节镜下 Bankart(AB)和 Latarjet 手术治疗肩关节前向不稳定的 30 天转归,包括住院时间、短期并发症、住院再入院、全因再次手术和死亡。
使用当前操作术语(Current Procedural Terminology)代码,从 2012 年至 2018 年在全国手术质量改进计划(National Surgical Quality Improvement Program)数据库中确定接受 AB 或 Latarjet-Bristow(LB)手术治疗的患者。采用最近邻倾向评分匹配法来解决任何潜在的人口统计学差异。比较术后 30 天内并发症的发生率,并使用单变量和多变量逻辑回归分析确定与术后并发症发生相关的危险因素。
共确定了 7519 例患者,其中 6990 例(93.0%)接受 AB 手术,529 例(7.0%)接受 LB 手术。在进行倾向评分匹配后,基线人口统计学特征无显著差异(P>.05)。AB 和 LB 两组之间总不良事件发生率无显著差异(P=.06)。LB 组(1.9%)与 AB 组(0%)相比,返回手术室的比率存在显著差异(P<.001)。再次手术中,40%是由于需要 revision stabilization(0.8%的所有 LB 病例),40%是进行灌洗和清创术。手术时间也存在显著差异(AB=87 分钟,LB=131 分钟;P<.0001)。
两组患者的 30 天总体并发症发生率均较低,AB 和 LB 患者的并发症发生率相似。然而,LB 组的短期再手术或 revision stabilization 率明显增加。
III 级,回顾性比较预后试验。