The Learning Curve for the Latarjet Procedure: A Systematic Review

Background: Anterior shoulder instability with significant glenoid bone loss is a challenging condition. The open Latarjet procedure is the established standard treatment method in this setting, but there is an increasing use of the arthroscopic technique. Purpose: To systematically review the current evidence in the literature to ascertain if the open or arthroscopic Latarjet procedure resulted in improved patient outcomes. Study Design: Systematic review and meta-analysis. Methods: A literature search of MEDLINE, EMBASE, and the Cochrane Library was performed based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines. Cohort studies comparing the open and arthroscopic Latarjet procedures for anterior shoulder instability were included. Clinical outcomes were compared, with all statistical analysis performed using Review Manager (version 5.3). A P value of <.05 was considered statistically significant. Results: Six clinical trials with 896 patients were included. The open and arthroscopic Latarjet procedures resulted in a similar number of total recurrent instability (2.0% vs 2.4%; P = .75), revision procedures (2.4% vs 5.4%; P = .06), and total complications (13.8% vs 11.9%; P = .50), but the open procedure had a lower rate of persistent apprehension (10.2% vs 35.7%; P < .05). In addition, after the learning curve, the operative time was similar between the 2 procedures. Conclusion: Both the open and arthroscopic Latarjet procedures result in significant improvements in patient function and outcome scores, with low rates of recurrent instability and similar complication rates. While technically challenging, the arthroscopic procedure has been shown to be a safe and viable alternative. However, there is a significant learning curve associated with the arthroscopic Latarjet procedure. The significant learning curve associated with this procedure suggests the arthroscopic procedure may be advisable to perform only in high-volume centers with experienced arthroscopists.

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The learning curve for the direct anterior total hip arthroplasty: a systematic review

International Orthopaedics ◽

10.1007/s00264-021-04986-7 ◽

2021 ◽

Author(s):

Leah Nairn ◽

Lauren Gyemi ◽

Kyle Gouveia ◽

Seper Ekhtiari ◽

Vickas Khanna

Keyword(s):

Systematic Review ◽

Total Hip Arthroplasty ◽

Learning Curve ◽

Hip Arthroplasty ◽

Total Hip

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Failed Latarjet procedure: a systematic review of surgery revision options

Journal of Orthopaedics and Traumatology ◽

10.1186/s10195-021-00587-7 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Matteo Buda ◽

Riccardo D’Ambrosi ◽

Enrico Bellato ◽

Davide Blonna ◽

Alessandro Cappellari ◽

...

Keyword(s):

Systematic Review ◽

Case Series ◽

Review Of The Literature ◽

Inclusion Criteria ◽

Latarjet Procedure ◽

Shoulder Stabilization ◽

Recurrent Instability ◽

Level Of Evidence ◽

Radiographic Outcomes

Abstract Background Revision surgery after the Latarjet procedure is a rare and challenging surgical problem, and various bony or capsular procedures have been proposed. This systematic review examines clinical and radiographic outcomes of different procedures for treating persistent pain or recurrent instability after a Latarjet procedure. Methods A systematic review of the literature was performed using the Medline, Cochrane, EMBASE, Google Scholar and Ovid databases with the combined keywords “failed”, “failure”, “revision”, “Latarjet”, “shoulder stabilization” and “shoulder instability” to identify articles published in English that deal with failed Latarjet procedures. Results A total of 11 studies (five retrospective and six case series investigations), all published between 2008 and 2020, fulfilled our inclusion criteria. For the study, 253 patients (254 shoulders, 79.8% male) with a mean age of 29.6 years (range: 16–54 years) were reviewed at an average follow-up of 51.5 months (range: 24–208 months). Conclusions Eden–Hybinette and arthroscopic capsuloplasty are the most popular and safe procedures to treat recurrent instability after a failed Latarjet procedure, and yield reasonable clinical outcomes. A bone graft procedure and capsuloplasty were proposed but there was no clear consensus on their efficacy and indication. Level of evidence Level IV Trial registration PROSPERO 2020 CRD42020185090—www.crd.york.ac.uk/prospero/

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Learning curve for laparoscopic cholecystectomy has not been defined: A systematic review

ANZ Journal of Surgery ◽

10.1111/ans.17021 ◽

2021 ◽

Author(s):

Elisa Reitano ◽

Nicola de'Angelis ◽

Elena Schembari ◽

Maria Clotilde Carrà ◽

Elisa Francone ◽

...

Keyword(s):

Systematic Review ◽

Laparoscopic Cholecystectomy ◽

Learning Curve

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Su1550 Establishing the Learning Curve for Achieving Competency in Performing Colonoscopy: a Systematic Review

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2014.02.294 ◽

2014 ◽

Vol 79 (5) ◽

pp. AB318

Author(s):

Neal Shahidi ◽

George Ou ◽

Jennifer J. Telford ◽

Robert a. Enns

Keyword(s):

Systematic Review ◽

Learning Curve

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Arthroscopic Bankart repair with remplissage versus Latarjet procedure for management of engaging Hill-Sachs lesions with subcritical glenoid bone loss in traumatic anterior shoulder instability: a systematic review and meta-analysis

Journal of Shoulder and Elbow Surgery ◽

10.1016/j.jse.2020.04.032 ◽

2020 ◽

Vol 29 (10) ◽

pp. 2163-2174

Author(s):

Haitham K. Haroun ◽

Mohamed H. Sobhy ◽

Amr A. Abdelrahman

Keyword(s):

Systematic Review ◽

Bone Loss ◽

Shoulder Instability ◽

Meta Analysis ◽

Glenoid Bone Loss ◽

Bankart Repair ◽

Anterior Shoulder Instability ◽

Latarjet Procedure ◽

Arthroscopic Bankart Repair

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The learning curve in transcatheter aortic valve implantation clinical studies: A systematic review

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462320000100 ◽

2020 ◽

Vol 36 (2) ◽

pp. 152-161

Author(s):

Anne-Pauline Thivilliers ◽

Rémi Ladarré ◽

Océane Merabti ◽

Caroline François ◽

Sarah Fontenay ◽

...

Keyword(s):

Systematic Review ◽

Aortic Valve ◽

Learning Curve ◽

Prospective Studies ◽

Quality Of Information ◽

The Past ◽

Transcatheter Aortic Valve ◽

Aortic Valve Implantation ◽

Valve Implantation

BackgroundTranscatheter aortic-valve implantation (TAVI) has become an essential alternative to surgical aortic-valve replacement in the treatment of symptomatic severe aortic stenosis, and this procedure requires technical expertise. The aim of this study was to identify prospective studies on TAVI from the past 10 years, and then to analyze the quality of information reported about the learning curve.Materials and methodsA systematic review of articles published between 2007 and 2017 was performed using PubMed and the EMBASE database. Prospective studies regarding TAVI were included. The quality of information reported about the learning curve was evaluated using the following criteria: mention of the learning curve, the description of a roll-in phase, the involvement of a proctor, and the number of patients suggested to maintain skills.ResultsA total of sixty-eight studies met the selection criteria and were suitable for analysis. The learning curve was addressed in approximately half of the articles (n = 37, 54 percent). However, the roll-in period was mentioned by only eight studies (12 percent) and with very few details. Furthermore, a proctorship was disclosed in three articles (4 percent) whereas twenty-five studies (37 percent) included authors that were proctors for manufacturers of TAVI.ConclusionMany prospective studies on TAVI over the past 10 years mention learning curves as a core component of successful TAVI procedures. However, the quality of information reported about the learning curve is relatively poor, and uniform guidance on how to properly assess the learning curve is still missing.

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