Background:

In cases of recurrent anterior shoulder instability with a glenoid defect, Latarjet procedures are widely used for stabilization. Although complications with this procedure have been reported, few studies have comprehensively analyzed issues related to the Latarjet procedure.

Purpose:

To identify the overall complication rate of the Latarjet procedure used for anterior shoulder instability and to compare the rate of complications between arthroscopic and open approaches.

Study Design:

Systematic review; Level of evidence, 4.

Methods:

PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed by using the PubMed, EMBASE, Scopus, and Cochrane Library databases. Data on complications were extracted and classified as intraoperative, postoperative, or instability-related for further analysis. Quality assessments were performed with criteria from the Methodological Index for Nonrandomized Studies (MINORS). A quantitative synthesis of data was conducted to compare the complication rates between arthroscopic and open approaches.

Results:

A total of 35 articles were included in this analysis. The MINORS score was 11.89. A total 2560 Latarjet procedures (2532 patients) were included. The overall complication rate was 16.1% (n = 412). The intraoperative complication rate was 3.4% (n = 87) and included a 1.9% (n = 48) incidence of nerve injuries and a 1.0% (n = 25) incidence of iatrogenic fractures. Screw problems, vascular injuries, and conversion arthroscopic to open surgery each occurred at a rate of <1%. The postoperative complication rate was 6.5% (n = 166), and the most common complication was nonunion (1.3%; n = 33). The instability-related complication rate was 6.2% (n = 159) and included a 1.5% (n = 38) rate of redislocation, a 2.9% (n = 75) rate of positive apprehension test, and a 1.0% (n = 26) rate of instability. Overall, 2.6% (n = 66) of patients required an unplanned secondary operation after the initial surgery. The arthroscopic approach was associated with a higher rate of intraoperative complications compared with the open approach (5.0% vs 2.9%; P =.020) and a lower rate of instability-related complications (3.1% vs 7.2%; P < .001).

Conclusion:

The Latarjet procedure for anterior shoulder instability results in an overall complication rate of 16.1% and a reoperation rate of 2.6%. However, serious complications at short-term follow-up appear rare. When the arthroscopic approach was used, the rate of intraoperative complications was higher, although instability-related complications were lower when compared with the open approach.

中文翻译：

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与 Latarjet 肩部稳定相关的并发症：系统评价

背景：

在肩关节盂缺损复发性肩关节前不稳定的情况下，Latarjet 手术被广泛用于稳定。尽管已经报道了该手术的并发症，但很少有研究全面分析与 Latarjet 手术相关的问题。

目的：

旨在确定用于治疗肩部前不稳定的 Latarjet 手术的总体并发症发生率，并比较关节镜手术和开放手术之间的并发症发生率。

学习规划：

系统审查；证据级别，4。

方法：

遵循 PRISMA（系统评价和荟萃分析的首选报告项目）指南，使用 PubMed、EMBASE、Scopus 和 Cochrane 图书馆数据库。提取并发症数据并分类为术中、术后或不稳定性相关，以供进一步分析。质量评估按照非随机研究方法学指数 (MINORS) 的标准进行。对数据进行定量综合，以比较关节镜手术和开放手术之间的并发症发生率。

结果：

本次分析共纳入 35 篇文章。未成年人得分为11.89。总共包括 2560 例 Latarjet 手术（2532 名患者）。总并发症率为 16.1% (n = 412)。术中并发症发生率为 3.4% (n = 87)，其中神经损伤发生率为 1.9% (n = 48)，医源性骨折发生率为 1.0% (n = 25)。螺钉问题、血管损伤以及关节镜手术转为开放手术的发生率均<1%。术后并发症发生率为 6.5%（n = 166），最常见的并发症是骨不连（1.3%；n = 33）。与不稳定性相关的并发症发生率为 6.2% (n = 159)，包括 1.5% (n = 38) 的再脱位率、2.9% (n = 75) 的阳性忧虑测试率和 1.0% (n = 26) 的再脱位率。 ) 不稳定率。总体而言，2.6% (n = 66) 的患者在初次手术后需要进行计划外的二次手术。与开放手术相比，关节镜手术的术中并发症发生率较高（5.0% vs 2.9%；P = .020），不稳定相关并发症发生率较低（3.1% vs 7.2%；P < .001） 。

结论：

Latarjet 手术治疗肩关节前不稳定的总体并发症率为 16.1%，再次手术率为 2.6%。然而，短期随访中出现严重并发症的情况很少见。当使用关节镜入路时，与开放入路相比，尽管与不稳定性相关的并发症较低，但术中并发症的发生率较高。