Complications following local anaesthetic transperineal prostate biopsies without antibiotic prophylaxis: An institution’s experience

2021 ◽  
pp. 205141582098766
Author(s):  
Joseph B John ◽  
Angus MacCormick ◽  
Ruaraidh MacDonagh ◽  
Mark J Speakman ◽  
Ramesh Vennam ◽  
...  
Keyword(s):  
Antibiotic Prophylaxis ◽  
Local Anaesthetic ◽  
Complication Rate ◽  
Admission Rate ◽  
Prophylactic Antibiotics ◽  
Complication Rates ◽  
Level Of Evidence ◽  
Hospital Admission Rate ◽  
Prostate Biopsies ◽  
Disease Characteristics

Objectives: This study aimed to describe a UK institution’s experience with local anaesthetic (LA) transperineal (TP) prostate biopsies (PB), and to report 30-day complications following LATPPB, including a large cohort that did not receive antibiotic prophylaxis. Patients and methods: A prospective database of 313 consecutive patients undergoing LATPPB was maintained, describing patient and disease characteristics, and complications. From September 2019 to January 2020, antibiotic prophylaxis was given before LATPPB ( n=149). Following a change to routine care, from January 2020 to July 2020, prophylactic antibiotics were not given before LATPPB ( n=164). A comparative analysis was performed to determine complication rates following antibiotic prophylaxis discontinuation using electronic hospital and primary care records. Results: Patient and disease characteristics were comparable in antibiotic and non-antibiotic cohorts, and representative of PB and prostate cancer cohorts described in the urological literature. The infection-related complication rate was 0.32% across all patients, and 0% for those not receiving antibiotic prophylaxis. The overall complication rate was 0.64%, and 0.61% for those not receiving antibiotic prophylaxis. There were no severe (Clavien–Dindo 3–5) complications. The unplanned hospital admission rate was 0.64%. Conclusion: The complication rate after LATPPB was low, with no infection-related complications in patients who did not receive antibiotic prophylaxis. This provides further evidence supporting the discontinuation of routine prophylactic antibiotics before TPPB. Level of evidence: Level 2b.

scholarly journals Admission and Acute Complication Rate for Outpatient Lumbar Microdiscectomy

2010 ◽  
Vol 37 (1) ◽  
pp. 49-53 ◽  
Author(s):  
Aria Fallah ◽  
Eric M. Massicotte ◽  
Michael G. Fehlings ◽  
Stephen J. Lewis ◽  
Yoga Raja Rampersaud ◽  
...  
Keyword(s):  
Complication Rate ◽  
Admission Rate ◽  
Complication Rates ◽  
Chi Square ◽  
Lumbar Microdiscectomy ◽  
Acute Complication ◽  
Admission Data ◽  
Improved Outcomes ◽  
Significant Difference ◽  
Revision Operations

Objective:Specialization is generally independently associated with improved outcomes for most types of surgery. This is the first study comparing the immediate success of outpatient lumbar microdiscectomy with respect to acute complication and conversion to inpatient rate. Long term pain relief is not examined in this study.Methods:Two separate prospective databases (one belonging to a neurosurgeon and brain tumor specialist, not specializing in spine (NS) and one belonging to four spine surgeons (SS)) were retrospectively reviewed. All acute complications as well as admission data of patients scheduled for outpatient lumbar microdiscectomy were extracted.Results:In total, 269 patients were in the NS group and 137 patients were in the SS group. The NS group averaged 24 cases per year while the SS group averaged 50 cases per year. Chi-square tests revealed no difference in acute complication rate [NS(6.7%), SS(7.3%)] (p>0.5) and admission rate [NS(4.1%), SS(5.8%)] (p=0.4) while the SS group had a significantly higher proportion of patients undergoing repeat microdiscectomy [NS(4.1%), SS(37.2%)] (p<0.0001). Excluding revision operations, there was no statistically significant difference in acute complication [NS(5.4%), SS(1.2%)] (p=0.09) and conversion to inpatient [NS(4.3%), SS(4.6%)] (p>0.5) rate. The combined acute complication and conversion to inpatient rate was 6.9% and 4.7% respectively.Conclusion:Based on this limited study, outpatient lumbar microdiscectomy can be apparently performed safely with similar immediate complication rates by both non-spine specialized neurosurgeons and spine surgeons, even though the trend favored the latter group for both outcome measures.

Postoperative complications in equine elective, clean orthopaedic surgery with/without antibiotic prophylaxis

2018 ◽  
Vol 46 (02) ◽  
pp. 81-86 ◽  
Author(s):  
Klaus Failing ◽  
Marc Koene ◽  
Kerstin Fey ◽  
Sabita Stöckle
Keyword(s):  
Postoperative Complications ◽  
Septic Arthritis ◽  
Antibiotic Prophylaxis ◽  
Surgical Procedures ◽  
Complication Rate ◽  
Clinical Relevance ◽  
Orthopaedic Surgery ◽  
Complication Rates ◽  
Perioperative Antibiotics ◽  
Type Of Surgery

Summary Objective: Retrospective analysis of postoperative complications in equines after clean, orthopaedic surgical procedures in order to detect differences between animals treated with antibiotics and horses without receiving these drugs. Material and methods: Details on 652 patients, surgical procedures and surgery-associated complications were compiled from horses being operated between June 2011 and January 2015. Antibiotic-receiving patients (n = 259) were tested for differences in complication rates and characteristics to controls (n = 393). Results: The total complication rate was 39.1 %. Increased swelling was observed most often (25.6 %), followed by exudation (7.5 %), fever without incisional alterations (2.3 %), suture dehiscence (1.8 %), and seroma (0.8 %). Seven patients (five treated, two controls) developed septic arthritis within a total of 463 arthroscopies (1.5 %). There were no significant differences in the development of postoperative complications, which were seen in 97/259 (37.5 %) antibiotic receiving patients and in 158/393 (40.2 %) controls. The application of perioperative antibiotics was significantly influenced by surgeon (p < 0.0001) and type of surgery (p = 0.0007) and increased with the number of surgical lesions (p = 0.03). In patients undergoing tendovaginoscopy/ bursoscopy, fasciotomy and neurectomy (n = 98), antibiotic prophylaxis was initiated less frequently than in other surgeries, e. g. combinations of surgeries, splint bone extraction, tenotomy, and arthroscopy (n = 554). Conclusion: Severe complications in equine clean orthopaedic surgery are rare and complication rates in patients either receiving perioperative antibiotics or not were not significantly different. Clinical relevance: Based on the results the use of antibiotics appears to be non-essential in uncomplicated elective orthopaedic interventions in the horse.

scholarly journals Update Experience of Surgery for Acute Limb Ischaemia in a District General Hospital – Are We Getting Any Better?

2009 ◽  
Vol 91 (8) ◽  
pp. 637-640 ◽  
Author(s):  
G Morris-Stiff ◽  
J D'Souza ◽  
S Raman ◽  
S Paulvannan ◽  
MH Lewis
Keyword(s):  
Limb Salvage ◽  
Symptom Onset ◽  
Local Anaesthetic ◽  
Prophylactic Antibiotics ◽  
High Morbidity ◽  
Limb Ischaemia ◽  
Complication Rates ◽  
Acute Limb Ischaemia ◽  
Number Of Patients ◽  
Increased Risk

INTRODUCTION The aims of this study were to audit results of a 10-year experience of surgery for acute limb ischaemia (ALI) in terms of limb salvage and mortality rates, and to compare results with a historical published series from our unit. PATIENTS AND METHODS All emergency operations performed during the period 1993–2003 were identified from theatre registers and patient notes reviewed to determine indications for, and outcome of, surgery. Data were compared to a similar cohort who underwent surgery from 1980 to 1990. RESULTS There was a 33% increase in workload from 87 to 116 patients between the two time periods. The number of patients with idiopathic ALI reduced (24% versus 4%; P < 0.05), and there were fewer smokers (71% versus 39%; P < 0.05) and a greater number of claudicants (17% versus 35%; P < 0.05) in those treated from 1993–2003. Latterly, more patients underwent pre-operative heparinisation (33% versus 80%; P < 0.05), received prophylactic antibiotics (14% versus 63%; P < 0.05), and had anaesthetic presence in theatre (46% versus 88%; P < 0.05). There was also a reduction in local anaesthetic procedures (80% versus 41%; P < 0.05). Despite increased pre-operative (15% versus 47%; P < 0.05) and on-table imaging (0% versus 16%; P < 0.05) technical success did not improve. Whilst complication rates were identical at 62%, there were fewer cardiovascular complications in the recent cohort. The 30-day mortality rate for embolectomy fell from 45% to 33%. Multivariate analysis revealed age > 70 years, prolonged symptom duration, ASA score ≥ III, lack of prophylactic antibiotics, absence of an anaesthetist, and operations performed under local anaesthetic to be associated with increased risk of mortality. Factors adversely affecting limb salvage included prolonged duration from symptom onset to operation, and a history of claudication or smoking. CONCLUSIONS Despite improvements in pre- and peri-operative management, arterial embolectomy/thrombectomy remains a procedure with a high morbidity and mortality. Further attempts to improve outcome must be directed at early diagnosis and referral as delay from symptom onset to surgery is a major determinant of outcome.

scholarly journals Outcome after Day-Care Surgery in a Major Teaching Hospital

1993 ◽  
Vol 21 (6) ◽  
pp. 822-827 ◽  
Author(s):  
G. A. Osborne ◽  
G. E. Rudkin
Keyword(s):  
General Anaesthesia ◽  
Teaching Hospital ◽  
Admission Rate ◽  
Community Support ◽  
Day Surgery ◽  
Patient Acceptance ◽  
Complication Rates ◽  
Hospital Admission Rate ◽  
Satisfactory Outcome ◽  
Care Surgery

Outcome has been measured for 6000 consecutive procedures in a major public teaching hospital day surgery unit. The unanticipated hospital admission rate was 1.34% and surgery-related admissions (0.95%) exceeded those related to anaesthesia (0.13%). Perioperative complications related to surgery (1:105) were more frequent than those related to anaesthesia (1:176) and pre-existing medical problems (1:500). Anaesthesia-related complications were more frequent with general anaesthesia (1:114) than with local anaesthesia plus sedation (1:780) or regional anaesthesia (1:180). Recovery times after general anaesthesia were longer than after other anaesthetic techniques but did not correlate with patient age (r = 0.04; P = 0.02) and only weakly correlated with procedure duration (r = 0.21; P < 0.01). At early follow-up, 4.0% of patients had presented to a local medical practitioner and 3.1% to a hospital accident and emergency service, usually for minor problems. Take home analgesia was adequate for 95% of patients and 98.9% were happy with the day surgery service. Day surgery in a teaching hospital can provide satisfactory outcome, with low complication rates, high patient acceptance and low community support requirements after patient discharge.

The use of antibiotic prophylaxis in hip arthroscopy is under-reported and lacks evidence-based guidelines: a systematic review and survey

2017 ◽  
Vol 3 (2) ◽  
pp. 105-109
Author(s):  
Seper Ekhtiari ◽  
Chloe E Haldane ◽  
Darren de SA ◽  
Nicole Simunovic ◽  
Ivan H Wong ◽  
...  
Keyword(s):  
Systematic Review ◽  
Antibiotic Prophylaxis ◽  
Hip Arthroscopy ◽  
Postoperative Infection ◽  
Practice Patterns ◽  
Surgical Techniques ◽  
High Volume ◽  
Prophylactic Antibiotics ◽  
Infection Rates ◽  
Level Of Evidence

ImportanceHip arthroscopy is an increasingly common orthopaedic procedure with postoperative infection rates<5%. With the growing challenge of antibiotic resistance and rising healthcare costs, it is important to establish whether antibiotic prophylaxis is routinely used in hip arthroscopy, and whether it is necessary.ObjectiveThe objectives of this review were to (1) report current practice patterns with regard to antibiotic prophylaxis for hip arthroscopy and (2) present the available evidence regarding the use of antibiotic prophylaxis in hip arthroscopy.Evidence reviewThe Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed in the execution and reporting of this study. The databases MEDLINE, EMBASE and PubMed were searched and screened in duplicate. Data regarding patient demographics, surgical indications, surgical techniques, use of antibiotic prophylaxis and adverse events were collected. Study quality was assessed in duplicate using Methodological Index for Non-Randomised Studies criteria. A survey was distributed to high-volume hip arthroscopists to gauge their practice patterns. Data were analysed and presented using descriptive statistics.FindingsNine studies of primarily level IV evidence (78%) and of fair quality were included. Overall, 592 patients (652 hips; 56.2% male) were included in the review, with a mean age of 40.6 years. Notably, 1069 otherwise eligible studies were excluded from this review because they did not report on their use (or lack thereof) of prophylactic antibiotics. Overall, 390 patients received routine antibiotic prophylaxis, 160 patients did not and 42 patients received prophylaxis only if an implant was used. Only three infections were reported among 652 operations, with all infections from studies that routinely used antibiotic prophylaxis. The survey had a 60% response rate (21/35), and revealed that 81% of respondents routinely provide prophylactic antibiotics, most commonly preoperative intravenous cefazolin (66.7%). The most common postoperative antibiotic was cephalexin.Conclusions and relevanceAntibiotic prophlyaxis use in hip arthroscopy is very under-reported. Routine prophylaxis was the most common practice pattern in both the literature and the survey. Overall, postoperative infection rates are extremely low. Future studies are required to prospectively assess the role of antibiotic prophylaxis in hip arthroscopy.Level of evidenceLevel IV, systematic review of level III and IV studies

scholarly journals COMPLICATIONS AND COST ANALYSIS OF HEMIPELVECTOMY FOR THE TREATMENT OF PELVIC TUMORS

2019 ◽  
Vol 27 (2) ◽  
pp. 104-107
Author(s):  
Mariana Tedeschi Benatto ◽  
Amira Mohamede Hussein ◽  
Nelson Fabrício Gava ◽  
Daniel Augusto Maranho ◽  
Edgard Eduard Engel
Keyword(s):  
Complication Rate ◽  
Histological Grade ◽  
Hospital Costs ◽  
Case Series ◽  
Pelvic Organ ◽  
Older Age ◽  
Complication Rates ◽  
Bone Reconstruction ◽  
Level Of Evidence ◽  
Postoperative Death

ABSTRACT Objective: Hemipelvectomy is a complex surgery with a high complication rate. Here, we aimed to identify factors related to the onset of complications and calculate their impacts on hospital costs. Methods: We evaluated 31 consecutive patients who underwent hemipelvectomy between 1999 and 2015. We assessed the clinical and radiographic data to determine the patients’ demographic factors, tumor and surgical characteristics, and complications. The individual hospital stays and financial balances were assessed up to 6 months following the index surgery. Results: The overall complication rate was 61% (19/31). Infection was the most prevalent complication (36%). Immediate postoperative death occurred in 5/31 patients (16%); another 5 (16%) died after hospital discharge due to disease progression. Histological grade, previous surgery, and previous radiotherapy were not associated with complications or infection. Acetabular resections, bone reconstruction, and longer operative times were associated with infection, whereas older age, pelvic organ involvement, and comorbidities were associated with immediate postoperative death. Complications and infection were associated with 4.8- and 5.9-fold increases in hospital costs, respectively. Conclusions: Acetabular resection and bone reconstruction are important factors that increase short-term complication rates, infection rates, and hospital costs. Mortality was associated with older age and adjacent pelvic tumor progression. Level of Evidence: IV, case series.

scholarly journals Biópsia Prostática Transretal Após Preparação Profilática do Recto com Iodo-Povidona: Estudo Prospectivo Randomizado

2018 ◽  
Vol 35 (1-2) ◽  
pp. 28-31
Author(s):  
José Pedro Cadilhe
Keyword(s):  
Urinary Tract ◽  
Prostate Biopsy ◽  
Povidone Iodine ◽  
Admission Rate ◽  
Infectious Complications ◽  
Prophylactic Antibiotics ◽  
Hospital Admission Rate ◽  
Urological Complications ◽  
Tract Infections ◽  
Rectal Preparation

Introduction: Transrectal ultrasound guided prostate biopsy (TRUS-Bx), according to the literature, can lead to urinary tract infections in up to 11% and sepsis in up to 2% of patients. We evaluate whether an original way to apply povidone-iodine rectal preparation just prior to TRUS-Bx can reduce infectious complications. Material and Methods: Between January 2014 and September 2016, 94 men in private office were prospectively randomized to two groups, before TRUS-Bx: • Rectal cleansing (an original transrectal “prostate massage” for about half a minute with 2.5 mL of betadine dermic solution 100 mg/mL) (n=47) or • No cleansing (n=47). All of the patients received prophylactic antibiotics: levofloxacin 500 mg PO for 7 days, beginning the day before procedure. Patients completed a telephone interview 4 days after undergoing the biopsy and went to the office 2 weeks after biopsy. The primary end point was the rate of infectious complications. An infectious complication when one or more of the following events occurred: 1) fever greater than 38.0Cº, 2) urinary tract infection or 3) sepsis (standardized definition). Student t test and multivariate regression analysis were used for data analysis. Results: Infectious complications developed in 6 cases (12.7%) in the non-rectal preparation group: five patients had fever without sepsis (11%) and one had sepsis (2%). In the povidone-iodine rectal preparation group there were no infectious complications (0.0%). Multivariate analysis did not identify any patient subgroups at significantly higher risk of infection after prostate biopsy. Of the 94 men who underwent TRUS-Bx 45 (47.9%) were diagnosed with prostate cancer and 3 (3.2%) had ASAP in the result. The hospital admission rate for urological complications within 30 days of the procedure was 1%, and only for infection related reasons (sepsis). Conclusion: The administration of quinolone-based prophylactic antibiotics and the simple use of 2.5 mL of povidone-iodine dermic solution in a transrectal prostate massage for Introduction: Transrectal ultrasound guided prostate biopsy (TRUS-Bx), according to the literature, can lead to urinary tract infections in up to 11% and sepsis in up to 2% of patients. We evaluate whether an original way to apply povidone-iodine rectal preparation just prior to TRUS-Bx can reduce infectious complications. Material and Methods: Between January 2014 and September 2016, 94 men in private office were prospectively randomized to two groups, before TRUS-Bx: • Rectal cleansing (an original transrectal “prostate massage” for about half a minute with 2.5 mL of betadine dermic solution 100 mg/mL) (n=47) or • No cleansing (n=47). All of the patients received prophylactic antibiotics: levofloxacin 500 mg PO for 7 days, beginning the day before procedure. Patients completed a telephone interview 4 days after undergoing the biopsy and went to the office 2 weeks after biopsy. The primary end point was the rate of infectious complications. An infectious complication when one or more of the following events occurred: 1) fever greater than 38.0Cº, 2) urinary tract infection or 3) sepsis (standardized definition). Student t test and multivariate regression analysis were used for data analysis. Results: Infectious complications developed in 6 cases (12.7%) in the non-rectal preparation group: five patients had fever without sepsis (11%) and one had sepsis (2%). In the povidone-iodine rectal preparation group there were no infectious complications (0.0%). Multivariate analysis did not identify any patient subgroups at significantly higher risk of infection after prostate biopsy. Of the 94 men who underwent TRUS-Bx 45 (47.9%) were diagnosed with prostate cancer and 3 (3.2%) had ASAP in the result. The hospital admission rate for urological complications within 30 days of the procedure was 1%, and only for infection related reasons (sepsis). Conclusion: The administration of quinolone-based prophylactic antibiotics and the simple use of 2.5 mL of povidone-iodine dermic solution in a transrectal prostate massage for

Comparing tolerability of local anaesthetic transperineal and transrectal prostate biopsies

2021 ◽  
pp. 205141582110240
Author(s):  
Benjamin Starmer ◽  
Nic Iordan ◽  
John McCabe
Keyword(s):  
Visual Analogue Scale ◽  
Local Anaesthetic ◽  
Analogue Scale ◽  
Specific Antigen ◽  
Transrectal Ultrasound ◽  
Level Of Evidence ◽  
Prostate Biopsies ◽  
Transrectal Biopsy ◽  
Scale Scores ◽  
Transperineal Biopsy

Objectives: Local anaesthetic transperineal prostate biopsies have been demonstrated as tolerable. However, to date, the tolerability has not been directly compared to the standard of care for transrectal biopsy. We set out to prospectively compare the tolerability of local anaesthetic transperineal and transrectal prostate biopsies. Patients and methods: All patients between 3 April 2019 to 6 December 2019 undergoing local anaesthetic transperineal / transrectal ultrasound biopsy were prospectively asked to complete a questionnaire using visual analogue scales assessing the tolerability of their biopsy. Results: 108 patients were included. Baseline characteristics (mean): age 66.4 years, prostate-specific antigen 13.7 ng/dl, prostate volume 48 ml. Of the patients 51% had ⩾ Gleason 3+4 prostate cancer. 56 patients had transperineal and 52 patients had transrectal biopsy. Median visual analogue scale scores (0–9: transperineal vs transrectal) for probe insertion, probe presence, local anaesthetic injection and taking biopsy were 3 vs 4 ( p=0.66), 3 vs 3 ( p=0.91), 3 vs 2 ( p=0.15) and 3 vs 3 ( p=0.18), respectively. Median visual analogue scale scores (0–3) for overall pain, embarrassment and how they would describe it to a friend were 1 vs 1 ( p=0.17), 0 vs 0 ( p=0.34) and 1 vs 1 ( p=0.2), respectively (transperineal vs transrectal ultrasound). 42 of the 56 patients in the transperineal group had prior transrectal biopsy. 24/42 patients described local anaesthetic transperineal biopsy as the same or better than transrectal; 15/42 described it as a little worse. Conclusion: Tolerability of local anaesthetic transperineal biopsy is comparable to transrectal biopsy. As such, we advocate the routine use of transperineal biopsy and to phase out the transrectal approach where possible. Level of evidence: 2b

scholarly journals Identifying complications and failure modes of innovative growing rod configurations using the (hybrid) magnetically controlled growing rod (MCGR) and the spring distraction system (SDS)

2021 ◽  
Author(s):  
Justin V. C. Lemans ◽  
Casper S. Tabeling ◽  
René M. Castelein ◽  
Moyo C. Kruyt
Keyword(s):  
Cost Effectiveness ◽  
Complication Rate ◽  
Failure Modes ◽  
Complication Rates ◽  
Level Of Evidence ◽  
Free Survival ◽  
Growing Rods ◽  
Growing Rod ◽  
Group 5

Abstract Background Magnetically controlled growing rods (MCGRs) offer non-invasive distractions in Early-Onset Scoliosis (EOS). However, implant-related complications are common, reducing its cost-effectiveness. To improve MCGRs functionality and cost-effectiveness, we often combine a single MCGR with a contralateral sliding rod (hybrid MCGR). Recently, we developed the spring distraction system (SDS) as an alternative, which provides continuous distraction forces through a helical spring. This study aims to identify complication rates and failure modes of EOS patients treated with either of these innovative systems. Methods This single-centre retrospective study included EOS patients treated with a (hybrid) MCGR or SDS between 2013 and 2018. Baseline demographics, and data regarding complications and implant growth were measured. Complication rate, complication profile, complication-free survival and implant growth were compared between groups. Results Eleven hybrid- and three bilateral MCGR patients (4.1-year follow-up) and one unilateral, eleven hybrid and six bilateral SDS patients (3.0-year follow-up) were included. Groups had similar age, sex, aetiology distribution, and pre-operative Cobb angle. Complication rate was 0.35 complications/patient/year for MCGR patients and 0.33 complications/patient/year for SDS patients. The most common complications were failure to distract (MCGR-group; 8/20 complications) and implant prominence (SDS-group; 5/18 complications). Median complication-free survival was 2.6 years, with no differences between groups (p = 0.673). Implant growth was significantly higher in the SDS-group (10.1 mm/year), compared to the MCGR-group (6.3 mm/year). Conclusion (Hybrid) MCGR and SDS patients have similar complication rates and complication-free survival. Complication profile differs between the groups, with frequent failure to distract leading to significantly reduced implant growth in (hybrid) MCGR patients, whereas SDS patients frequently exhibit implant prominence and implant kyphosis. Level of evidence III.

scholarly journals Latarjet Procedure for Anterior Glenohumeral Instability: Early Postsurgical Complications for Primary Coracoid Transfer Versus Revision Coracoid Transfer After Failed Prior Stabilization

2020 ◽  
Vol 8 (6) ◽  
pp. 232596712092462
Author(s):  
Gary F. Updegrove ◽  
Patrick S. Buckley ◽  
Ryan M. Cox ◽  
Stephen Selverian ◽  
Manan S. Patel ◽  
...  
Keyword(s):  
Revision Surgery ◽  
Complication Rate ◽  
Primary Group ◽  
Complication Rates ◽  
Latarjet Procedure ◽  
Glenohumeral Instability ◽  
Level Of Evidence ◽  
Coracoid Transfer ◽  
Primary Surgery

Background: The Latarjet procedure (coracoid transfer) is often used to successfully treat failed instability procedures. However, given the reported increased complication rates in primary Latarjet surgery, there is a heightened concern for complications in performing the Latarjet procedure as revision surgery. Purpose: To evaluate the early outcomes and complications of the Latarjet procedure as primary surgery compared with revision surgery. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 157 patients were included and retrospectively reviewed: 103 patients in the revision group and 54 patients in the primary group. Patients were evaluated by physical examination findings as well as by documentation of complications and reoperations extracted from their electronic medical records. Results: The mean follow-up was 7.8 ± 11.0 months for the primary group and 7.0 ± 13.2 months for the revision group. There were no significant differences in overall complication rates between the primary and revision groups (16.7% vs 8.7%, respectively; P = .139). The complication rate was significantly higher in patients in the revision group who had undergone a prior open procedure compared with those who had undergone only arthroscopic procedures (30.0% vs 4.1%, respectively; P < .001). Of those patients who sustained a complication, 7 of the 9 underwent a reoperation in the primary group (13.0%), and 7 of the 9 did so in the revision group (6.8%); the risk of reoperations was not different between groups ( P = .198). There were 4 patients in the primary group (7.4%) and 5 patients in the revision group (4.9%) who experienced recurrent dislocations during the follow-up period ( P = .513). There was no difference in postoperative range of motion. Conclusion: The Latarjet procedure is a reasonable option for the treatment of failed arthroscopic instability repair with an early complication rate similar to that found in primary Latarjet surgery.

Sign in / Sign up

Export Citation Format

Share Document