Castropil Wagner, Mauad Juliana Ribeiro, Amorim Fernando Henrique Barcelos, Bitar Alexandre Carneiro, Garofo Antonio Guilherme Padovani, Schor Breno
Instituto Vita, Department of Orthopedic Surgery, Sao Paulo, Brazil.
Hospital Beneficiência Portuguesa, Department of Orthopedic Surgery, Sao Paulo, Brazil.
Acta Ortop Bras. 2024 Oct 28;32(5):e277567. doi: 10.1590/1413-785220243205e277567. eCollection 2024.
This study aims to analyze the learning curves in performing the arthroscopic Latarjet surgery.
This was an observational, retrospective, single-center study. All cases of arthroscopic Latarjet performed in this institution from 2016 to 2021 were included. The data analyzed were surgical time (of the chief surgeon alone and the group of surgeons), complications, and time until the return to sports activities. Technical observations about the learning process were also reported.
In total, 50 consecutive cases were included (93% retention of the initial sample identified at the institution). The decrease in surgical time was presented logarithmically and showed a decrease in time both for the individualized analysis of the senior surgeon (r = -0.67, p < 0.001) and for the surgical group (r = -0.476, p < 0.001). Mean operating time (and standard deviation) dropped from 235 minutes (73) in the first 10 cases to 156 minutes (34) for the subsequent cases (p < 0.001). In the first 20 cases, five intercurrences were recorded and three reoperations were performed, whereas subsequent cases presented only one intercurrence requiring surgical intervention (p = 0.032). The median time to return to sport was nine months for the first 20 cases versus six months for subsequent cases (p = 0.001).
The learning curve for the arthroscopic Latarjet procedure showed a progressive decrease in operative time, complications, and time to return to sports activities. This suggests that the surgeon developed the necessary skills and confidence to reach a plateau of expertise to perform the surgical procedure.
本研究旨在分析关节镜下Latarjet手术的学习曲线。
这是一项观察性、回顾性、单中心研究。纳入了2016年至2021年在本机构进行的所有关节镜下Latarjet手术病例。分析的数据包括手术时间（仅主刀医生的以及手术团队的）、并发症以及恢复体育活动的时间。还报告了关于学习过程的技术观察结果。
总共纳入了50例连续病例（占机构最初确定样本的93%）。手术时间呈对数下降，无论是对资深外科医生的个体化分析（r = -0.67，p < 0.001）还是对手术团队（r = -0.476，p < 0.001），时间均有所减少。平均手术时间（及标准差）从前10例的235分钟（73）降至后续病例的156分钟（34）（p < 0.001）。在前20例中，记录到5次并发情况，进行了3次再次手术，而后续病例仅出现1次需要手术干预的并发情况（p = 0.032）。前20例恢复运动的中位时间为9个月，而后续病例为6个月（p = 0.001）。
关节镜下Latarjet手术的学习曲线显示手术时间、并发症以及恢复体育活动的时间逐渐减少。这表明外科医生培养了必要的技能和信心，达到了进行该手术的专业水平平台期。
