Is the learning curve for arthroscopic Latarjet procedure facilitated by a specific step-by-step guiding system for the surgical technique?

Objectives: Treating anterior shoulder instability with the arthroscopic Latarjet procedure is a complex, operator-dependent technique that requires a learning curve. The objective of the study is to compare a guided technique with cortical button fixation and a non-guided technique with screw fixat...

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Published in:Orthopaedic journal of sports medicine 2021-02, Vol.9 (2_suppl)
Main Authors: Belas, Maxime, Gaujac, Nicolas, Bouche, Pierre Alban, Charousset,MD, Christophe
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Language:English
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Arthroscopy
Medical procedures
Orthopedics
Sports medicine
Surgical techniques
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Gaujac, Nicolas
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description Objectives: Treating anterior shoulder instability with the arthroscopic Latarjet procedure is a complex, operator-dependent technique that requires a learning curve. The objective of the study is to compare a guided technique with cortical button fixation and a non-guided technique with screw fixation. Methods: This is a retrospective study including 72 consecutive patients who underwent surgery for recurrent anterior shoulder instability by the arthroscopic Latarjet procedure, with a mean age of 26 years and minimum clinical follow-up of 6 months. The same surgeon performed all the surgeries. The procedure was performed either with an instrument set and dedicated instrumentation that guides the different surgical steps and fixed by two cortical buttons connected by loops of a continuous thread (Group A) or with a specific instrument set and fixed by two cortical screws (Group B). We compared the difficulty of the different surgical steps, each rated from 1 to 5 (1 being the simplest and 5 the most difficult), the number of procedures required to attain a level of difficulty, the operating time and the intraoperative or postoperative complications. Results: Coracoid preparation had a score of 1.3 in group A versus 2.9 in group B (p
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The objective of the study is to compare a guided technique with cortical button fixation and a non-guided technique with screw fixation. Methods: This is a retrospective study including 72 consecutive patients who underwent surgery for recurrent anterior shoulder instability by the arthroscopic Latarjet procedure, with a mean age of 26 years and minimum clinical follow-up of 6 months. The same surgeon performed all the surgeries. The procedure was performed either with an instrument set and dedicated instrumentation that guides the different surgical steps and fixed by two cortical buttons connected by loops of a continuous thread (Group A) or with a specific instrument set and fixed by two cortical screws (Group B). We compared the difficulty of the different surgical steps, each rated from 1 to 5 (1 being the simplest and 5 the most difficult), the number of procedures required to attain a level of difficulty, the operating time and the intraoperative or postoperative complications. Results: Coracoid preparation had a score of 1.3 in group A versus 2.9 in group B (p&lt;0.001) with a difficulty level of 1 as of 19 procedures. The Subscapularis split had a score of 1.9 in group A versus 3.2 in group B (p&lt;0.001) with a level as of 15 procedures. Horizontal positioning of the bone block scored 1.4 in group A versus 1.8 in group B (p=0.019) with a level as of 15 procedures. The mean operating time was 95 minutes in group A and 123 minutes in group B (p&lt;0.0001). There was one coracoid fracture in group A, one case of sepsis and 2 repeat procedures for screw removal in group B, and 2 reversible neurological complications in each group. Conclusion: The Latarjet procedure performed under arthroscopy remains a difficult procedure. An instrument set and dedicated instrumentation with reciprocating rasp and saw, posterior glenoid drill guide and subscapularis retractors allow faster and more reproducible learning.</description><identifier>ISSN: 2325-9671</identifier><identifier>EISSN: 2325-9671</identifier><identifier>DOI: 10.1177/2325967121S00003</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Arthroscopy ; Medical procedures ; Orthopedics ; Sports medicine ; Surgical techniques</subject><ispartof>Orthopaedic journal of sports medicine, 2021-02, Vol.9 (2_suppl)</ispartof><rights>The Author(s) 2021</rights><rights>The Author(s) 2021. This work is licensed under the Creative Commons Attribution – Non-Commercial – No Derivatives License https://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>The Author(s) 2021 2021 SAGE Publications</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7917945/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2547874604?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,21965,25752,27852,27923,27924,37011,44589,44944,45332,53790,53792</link.rule.ids></links><search><creatorcontrib>Belas, Maxime</creatorcontrib><creatorcontrib>Gaujac, Nicolas</creatorcontrib><creatorcontrib>Bouche, Pierre Alban</creatorcontrib><creatorcontrib>Charousset,MD, Christophe</creatorcontrib><title>Is the learning curve for arthroscopic Latarjet procedure facilitated by a specific step-by-step guiding system for the surgical technique?</title><title>Orthopaedic journal of sports medicine</title><description>Objectives: Treating anterior shoulder instability with the arthroscopic Latarjet procedure is a complex, operator-dependent technique that requires a learning curve. The objective of the study is to compare a guided technique with cortical button fixation and a non-guided technique with screw fixation. Methods: This is a retrospective study including 72 consecutive patients who underwent surgery for recurrent anterior shoulder instability by the arthroscopic Latarjet procedure, with a mean age of 26 years and minimum clinical follow-up of 6 months. The same surgeon performed all the surgeries. The procedure was performed either with an instrument set and dedicated instrumentation that guides the different surgical steps and fixed by two cortical buttons connected by loops of a continuous thread (Group A) or with a specific instrument set and fixed by two cortical screws (Group B). We compared the difficulty of the different surgical steps, each rated from 1 to 5 (1 being the simplest and 5 the most difficult), the number of procedures required to attain a level of difficulty, the operating time and the intraoperative or postoperative complications. Results: Coracoid preparation had a score of 1.3 in group A versus 2.9 in group B (p&lt;0.001) with a difficulty level of 1 as of 19 procedures. The Subscapularis split had a score of 1.9 in group A versus 3.2 in group B (p&lt;0.001) with a level as of 15 procedures. Horizontal positioning of the bone block scored 1.4 in group A versus 1.8 in group B (p=0.019) with a level as of 15 procedures. The mean operating time was 95 minutes in group A and 123 minutes in group B (p&lt;0.0001). There was one coracoid fracture in group A, one case of sepsis and 2 repeat procedures for screw removal in group B, and 2 reversible neurological complications in each group. 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An instrument set and dedicated instrumentation with reciprocating rasp and saw, posterior glenoid drill guide and subscapularis retractors allow faster and more reproducible learning.</description><subject>Arthroscopy</subject><subject>Medical procedures</subject><subject>Orthopedics</subject><subject>Sports medicine</subject><subject>Surgical techniques</subject><issn>2325-9671</issn><issn>2325-9671</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>AFRWT</sourceid><sourceid>PIMPY</sourceid><recordid>eNp1kU1LxDAQhoMouKx79xjwXG3Tpmkviix-LCx4UM8hSadtlm5bk3Shv8E_beoufoG5TGbyzjNvEoTOo_Ayihi7IjGhecoiEj2HfsVHaDaVgql2_GN_ihbWbiZJRqM8ZjP0vrLY1YAbEKbVbYXVYHaAy85gYVxtOqu6Xiu8Fk6YDTjcm05BMRivEUo32gkHBZYjFtj2oHTpxdZBH8gxmCKuBl1MYDv6dPtJngbawVRaiQY7UHWr3wa4OUMnpWgsLA5xjl7v716Wj8H66WG1vF0HioRJHBQlzSQDlqRSUVqAIkAhppJAUTJZllL6-yW5lGmasjBmIvNZTGQR5kBTkcZzdL3n9oPcQqGgdUY0vDd6K8zIO6H575NW17zqdpzlEcsT6gEXB4DpvHHr-KYbTOs9c0ITlnlr3ugchXuV8q9oDZRfE6KQT9_G_36bbwn2LVZU8A39V_8Bf5SbTQ</recordid><startdate>20210226</startdate><enddate>20210226</enddate><creator>Belas, Maxime</creator><creator>Gaujac, Nicolas</creator><creator>Bouche, Pierre Alban</creator><creator>Charousset,MD, Christophe</creator><general>SAGE Publications</general><general>Sage Publications Ltd</general><scope>AFRWT</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>5PM</scope></search><sort><creationdate>20210226</creationdate><title>Is the learning curve for arthroscopic Latarjet procedure facilitated by a specific step-by-step guiding system for the surgical technique?</title><author>Belas, Maxime ; 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Medical Complete (Alumni)</collection><collection>Nursing &amp; Allied Health Database (Alumni Edition)</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>Publicly Available Content (ProQuest)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Orthopaedic journal of sports medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Belas, Maxime</au><au>Gaujac, Nicolas</au><au>Bouche, Pierre Alban</au><au>Charousset,MD, Christophe</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Is the learning curve for arthroscopic Latarjet procedure facilitated by a specific step-by-step guiding system for the surgical technique?</atitle><jtitle>Orthopaedic journal of sports medicine</jtitle><date>2021-02-26</date><risdate>2021</risdate><volume>9</volume><issue>2_suppl</issue><issn>2325-9671</issn><eissn>2325-9671</eissn><abstract>Objectives: Treating anterior shoulder instability with the arthroscopic Latarjet procedure is a complex, operator-dependent technique that requires a learning curve. The objective of the study is to compare a guided technique with cortical button fixation and a non-guided technique with screw fixation. Methods: This is a retrospective study including 72 consecutive patients who underwent surgery for recurrent anterior shoulder instability by the arthroscopic Latarjet procedure, with a mean age of 26 years and minimum clinical follow-up of 6 months. The same surgeon performed all the surgeries. The procedure was performed either with an instrument set and dedicated instrumentation that guides the different surgical steps and fixed by two cortical buttons connected by loops of a continuous thread (Group A) or with a specific instrument set and fixed by two cortical screws (Group B). We compared the difficulty of the different surgical steps, each rated from 1 to 5 (1 being the simplest and 5 the most difficult), the number of procedures required to attain a level of difficulty, the operating time and the intraoperative or postoperative complications. Results: Coracoid preparation had a score of 1.3 in group A versus 2.9 in group B (p&lt;0.001) with a difficulty level of 1 as of 19 procedures. The Subscapularis split had a score of 1.9 in group A versus 3.2 in group B (p&lt;0.001) with a level as of 15 procedures. Horizontal positioning of the bone block scored 1.4 in group A versus 1.8 in group B (p=0.019) with a level as of 15 procedures. The mean operating time was 95 minutes in group A and 123 minutes in group B (p&lt;0.0001). There was one coracoid fracture in group A, one case of sepsis and 2 repeat procedures for screw removal in group B, and 2 reversible neurological complications in each group. 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subjects Arthroscopy
Medical procedures
Orthopedics
Sports medicine
Surgical techniques
title Is the learning curve for arthroscopic Latarjet procedure facilitated by a specific step-by-step guiding system for the surgical technique?
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