Short-Term Complications of Arthroscopic Bristow or Latarjet Procedure with Screw Versus Suture-Button Fixation: A Prospective Study of 308 Consecutive Cases by a Single Surgeon.

Zhenxing Shao,Yanfang Jiang,Qingfa Song,Hangle Wang,Hao Luo,Xu Cheng,Guoqing Cui
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Abstract

BACKGROUND This study aimed to investigate the short-term complications (minimum 1-year follow-up) after either an arthroscopic Bristow or Latarjet procedure for anterior shoulder instability utilizing screw or suture-button fixation. METHODS Patients undergoing arthroscopic Bristow or Latarjet procedures between November 2016 and April 2021 were enrolled. Data were collected at baseline, 3 months, 6 months, and every year after surgery. Risks of postoperative complications and unplanned reoperations were assessed. A multivariable regression model was used to identify risk factors for complications and to determine the association of complications with patient-reported outcomes. RESULTS A total of 412 patients (425 shoulders) undergoing arthroscopic Bristow or Latarjet procedures performed by a single surgeon between November 2016 and April 2021 were reviewed. Two hundred and ninety-nine patients (308 shoulders, 76.2% of 404 eligible) with a mean follow-up of 22.3 ± 4.2 months were included for analysis. Two hundred and sixty-nine shoulders (87.3%) underwent a Bristow procedure (165 with screw and 104 with suture-button fixation), while 39 (12.7%) underwent a Latarjet procedure (18 with screw and 21 with suture-button fixation). Eighty-two patients (83 shoulders) reported a total of 85 complications within 2 years after surgery, with an overall complication rate of 26.9%. The rates of recurrent dislocation or subluxation and infection were 1.9% and 0.6%, respectively, while a total of 4 (1.3%) of the shoulders had unplanned reoperations. The most common complications were graft-related (11.7%), followed by complications involving neurologic symptoms (10.7%). The overall, graft, and neurologic complication rates following Bristow or Latarjet procedures were 27.1% versus 25.6%, 12.3% versus 7.7%, and 10.0% versus 15.4%, respectively. Compared with the Bristow technique with screw fixation, Bristow with suture-button fixation yielded a lower risk of any complications (odds ratio [OR], 0.55; p = 0.04). Paying with rural insurance and poor sleep quality prior to surgery were associated with increased risk of any complications. CONCLUSIONS Compared with arthroscopic Bristow procedures with screw fixation, Bristow procedures with suture-button fixation resulted in a lower overall complication risk. Both patient demographic and implant-specific factors were associated with the development of a complication. LEVEL OF EVIDENCE Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.
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采用螺钉固定与缝线扣固定的关节镜 Bristow 或 Latarjet 手术的短期并发症:一位外科医生对 308 例连续病例的前瞻性研究。
背景本研究旨在调查使用螺钉或缝合扣固定治疗肩关节前侧不稳定的关节镜 Bristow 或 Latarjet 术后的短期并发症(至少随访 1 年)。方法纳入了 2016 年 11 月至 2021 年 4 月间接受关节镜 Bristow 或 Latarjet 术的患者。收集基线、术后 3 个月、6 个月和每年的数据。评估了术后并发症和计划外再次手术的风险。结果在2016年11月至2021年4月期间,共有412名患者(425个肩关节)接受了由一名外科医生实施的关节镜布里斯托或Latarjet手术。纳入分析的患者有 299 人(308 个肩关节,占符合条件的 404 人的 76.2%),平均随访时间为 22.3 ± 4.2 个月。269 例肩关节患者(87.3%)接受了布里斯托手术(165 例采用螺钉固定,104 例采用缝合扣固定),39 例患者(12.7%)接受了拉塔杰特手术(18 例采用螺钉固定,21 例采用缝合扣固定)。82名患者(83个肩关节)在术后两年内共报告了85例并发症,总并发症发生率为26.9%。复发性脱位或半脱位和感染的发生率分别为1.9%和0.6%,共有4例(1.3%)肩关节患者进行了计划外再手术。最常见的并发症是移植物相关并发症(11.7%),其次是神经症状并发症(10.7%)。Bristow或Latarjet手术后的总体、移植物和神经系统并发症发生率分别为27.1%对25.6%、12.3%对7.7%和10.0%对15.4%。与使用螺钉固定的布里斯托技术相比,使用缝合扣固定的布里斯托技术出现任何并发症的风险较低(几率比 [OR],0.55;P = 0.04)。结论与使用螺钉固定的关节镜布里斯托手术相比,使用缝合扣固定的布里斯托手术的总体并发症风险较低。患者人口统计学因素和植入物特异性因素都与并发症的发生有关。有关证据等级的完整描述,请参阅 "作者须知"。
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