scholarly journals Comparative Systematic Review of Fixation Methods of the Coracoid and Conjoined Tendon in the Anterior Glenoid to Treat Anterior Shoulder Instability

2019 ◽  
Vol 7 (1) ◽  
pp. 232596711882053 ◽  
Author(s):  
Jose Carlos Garcia ◽  
Felipe Machado do Amaral ◽  
Renan Juhasz Belchior ◽  
Lucas Queiroz de Carvalho ◽  
Gregory George Markarian ◽  
...  
Keyword(s):  
Systematic Review ◽  
Shoulder Instability ◽  
Meta Analysis ◽  
Japanese Orthopaedic Association ◽  
Coracoid Process ◽  
Latarjet Procedure ◽  
Significant Difference ◽  
Anterior Glenoid ◽  
The Mean ◽  
Process Transfer

Background: Coracoid process transfer for the treatment of recurrent glenohumeral dislocations is a safe and reliable procedure; however, there is no consensus as to which is the best method, the Bristow or Latarjet procedure. Purpose: To analyze the results of coracoid process transfer for the treatment of recurrent glenohumeral dislocations and to compare the results of this transfer between the Bristow and Latarjet techniques. Study Design: Systematic review; Level of evidence, 4. Methods: The databases surveyed for this review included J-STAGE; Cochrane Bone, Joint and Muscle Trauma Group Specialized Register; Cochrane Controlled Register of Trials; MEDLINE; Ovid; Embase; Google Scholar; and CINAHL. Inclusion criteria consisted of (1) studies related to anterior glenohumeral dislocations treated with transfer of the coracoid process to the anterior glenoid rim and (2) studies that could provide data to perform at least 1 meta-analysis or other statistical evaluation. Titles and abstracts were reviewed for inclusion; thereafter, outcomes and the risk of bias were extracted. Statistical analyses were performed according to the nature of the data. When possible, the 95% CI was included. Results: Of the 779 studies found, 63 were able to provide data assessing 3395 shoulders. There were no randomized, blinded, or double-blinded trials. The recurrence of dislocations was assessed in 41 studies that used the Bristow technique (n = 2346 shoulders; percentage redislocations [mean ± SE], 1.00% ± 0.20%) and 18 studies that used the Latarjet technique (n = 930 shoulders; percentage redislocations, 2.13% ± 0.49%) ( P = .04). The mean loss of external rotation was 12.91° for the Bristow procedure (n = 1440 shoulders) and 11.70° for the Latarjet procedure (n = 243 shoulders). The mean quality-of-life outcome scores were as follows for the Bristow and Latarjet procedures, respectively: Rowe score, 92.06 and 89.33; Western Ontario Shoulder Instability Index score, 16.44% and 19.68%; Japanese Orthopaedic Association score, 93.28 and 92.00; and American Shoulder and Elbow Surgeons score, 91.00 and 89.90. Conclusion: Transferring the coracoid to the anteroinferior border of the glenoid through the subscapularis tendon is effective, regardless of the technique. When comparing the Bristow and Latarjet techniques, the recurrence of dislocations was the only outcome that could undergo a meta-analysis, and it presented a statistically significant difference in favor of the Bristow procedure. All other outcomes presented no clinically significant differences between their effect sizes. More studies presenting better methodology are still needed to achieve more robust conclusions.

scholarly journals The Effectiveness of Microneedling Therapy on The Severity of Acne Scars According to Goodman and Baron: A Systematic review and meta-analysis

2022 ◽  
pp. 48
Author(s):  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Control Group ◽  
Skin Damage ◽  
Acne Scar ◽  
Acne Scars ◽  
Significant Difference ◽  
Acne Scarring ◽  
The Mean ◽  
Z Value

Background: The emergence of acne scars due to skin damage in the acne healing process and causes psychological effects. The management of acne scars can be done in several methods. Microneedling is a very simple, safe, effective, and minimally invasive therapeutic technique compared to other therapeutic modalities in acne scars. The resulting wound is micro-sized, and promotes the growth of growth factors and collagen production. We aimed to assess the effectiveness of using microneedling as an acne scar treatment option. A systematic review and meta-analysis were qualitatively and quantitatively conducted from RCTs, assessing the effectiveness of microneedling in reducing the severity of acne scars according to Goodman and Baron in the treatment of acne scars. Methods: Medline Pubmed, PMC, Scopus, Google Scholar, and JDC library, eligible search. Ten studies (n=514) were analyzed qualitatively with 2 studies (n=53 subjects) and quantitatively analyzed by 2 studies (n=90 subjects). Both analyzes were included in the meta-analysis. The mean age of the participants was 40.5 years. The application of microneedling intervention as monotherapy or a combination in patients with acne scarring was followed for at least 16 weeks, the results obtained were the mean reduction in the degree of acne scarring after microneedling. Result: The combination of microneedling treatment obtained a qualitative decrease in the degree of acne scars according to Goodman and Baron with a Z value (-4.299) and P=<0.001 lower than the control (PRP) with a significant difference. The quantitative decrease in the degree of acne scars according to Goodman and Baron obtained a Z value (-4.681) and P=<0.001 lower than the control (PRP) with a significant difference. Quantitative reduction in the degree of acne scars according to Goodman and Baron on single therapy between treatment and control with a value of Z (-3.536) and P=<0.001 lower than control (fractional CO2) with a significant difference. The results of the degree of acne scars in the group treated with microneedling alone or in combination were lower than the control group. The mean before and after therapy compared to the control there was a significant difference. Conclusion. The results of a systematic review, concluded that the group treated with microneedling had a decrease in the degree of acne scarring according to Goodman and Baron with P=<0.001 compared to before treatment. The decrease was shown in the difference in Z values, which was significantly greater than the control given other therapies. Microneedling therapy can be an alternative therapy option for acne scar patients who are unresponsive to previous therapy or in conditions where there are contraindications to other therapies.

scholarly journals Differences in pregnancy and perinatal outcomes among symptomatic versus asymptomatic COVID-19-infected pregnant women: a systematic review and meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Durray Shahwar A. Khan ◽  
La-Raib Hamid ◽  
Anna Ali ◽  
Rehana A. Salam ◽  
Nadeem Zuberi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Pregnant Women ◽  
Low Birthweight ◽  
Meta Analysis ◽  
Perinatal Outcomes ◽  
Respiratory Disorder ◽  
Significant Difference ◽  
The Mean ◽  
In Pregnancy

Abstract Background There is dearth of information on COVID-19’s impact on pregnant women. However, literature reported trends of COVID-19 differ, depending on the presence of clinical features upon presentation. Objective This systematic review aimed to assess differences in risk factors, management, complications, and pregnancy and perinatal outcomes in symptomatic vs. asymptomatic pregnant women with confirmed SARS-CoV-2 infection. Methods A search was run on electronic databases to identify studies reporting COVID-19 in pregnancy. Meta-analysis was performed and odds ratios and mean difference with 95% confidence intervals were calculated using Review Manager 5.4. Review Prospero registration number CRD42020204662. Results We included ten articles reporting data from 3158 pregnancies; with 1900 symptomatic and 1258 asymptomatic pregnant women. There was no significant difference in the mean age, gestational age, and body mass index between the two groups. The meta-analysis suggested that pregnant women who were obese (OR:1.37;95%CI:1.15 to 1.62), hypertensive (OR:2.07;95%CI:1.38 to 3.10) or had a respiratory disorder (OR:1.64;95%CI:1.25 to 2.16), were more likely to be symptomatic when infected with SARS-CoV-2. Pregnant women with Black (OR:1.48;95%CI:1.19 to 1.85) or Asian (OR:1.64;95%CI:1.23 to 2.18) ethnicity were more likely to be symptomatic while those with White ethnicity (OR:0.63;95%CI:0.52 to 0.76) were more likely to be asymptomatic. Cesarean-section delivery (OR:1.40;95%CI:1.17 to 1.67) was more likely amongst symptomatic pregnant women. The mean birthweight(g) (MD:240.51;95%CI:188.42 to 293.51), was significantly lower, while the odds of low birthweight (OR:1.85;95%CI:1.06 to 3.24) and preterm birth (< 37 weeks) (OR:2.10;95%CI:1.04 to 4.23) was higher amongst symptomatic pregnant women. Symptomatic pregnant women had a greater requirement for maternal ICU admission (OR:13.25;95%CI:5.60 to 31.34) and mechanical ventilation (OR:15.56;95%CI:2.96 to 81.70) while their neonates had a higher likelihood for Neonatal Intensive Care Unit admission (OR:1.96;95%CI:1.59 to 2.43). The management strategies in the included studies were poorly discussed, hence could not be analyzed. Conclusion The evidence suggests that the presence of risk factors (co-morbidities and ethnicity) increased the likelihood of pregnant women being symptomatic. Higher odds of complications were also observed amongst symptomatic pregnant women. However, more adequately conducted studies with adjusted analysis and parallel comparison groups are required to reach conclusive findings.

scholarly journals Efficacy Comparison of Intravitreal Anti-VEGF Therapy for Three Subtypes of Neovascular Age-Related Macular Degeneration: A Systematic Review and Meta-Analysis

2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Jianqing Li ◽  
Jiayi Xu ◽  
Yiyi Chen ◽  
Jiaju Zhang ◽  
Yihong Cao ◽  
...  
Keyword(s):  
Systematic Review ◽  
Macular Degeneration ◽  
Meta Analysis ◽  
Age Related Macular Degeneration ◽  
Cochrane Library ◽  
Anti Vegf ◽  
Age Related ◽  
Significant Difference ◽  
The Mean

Purpose. Intravitreal antivascular endothelial growth factor (anti-VEGF) therapy has been widely used for the treatment of neovascularization (NV) secondary to age-related macular degeneration (AMD). This study aimed to compare the efficacy among different subtypes of neovascular age-related macular degeneration (nAMD). Methods. PubMed, Embase, and the Cochrane Library were searched for eligible studies. We performed meta-analysis using Review Manager 5.3 and Stata/SE 12.0. Results. A total of 24 studies met our inclusion criteria and were included in the systematic review. At 3 months, the mean logarithm of the minimum angle of resolution (logMAR) improvements were −0.09, −0.18, and −0.23 for type 1, 2, and 3, respectively, while the mean macular thickness (MT) changes were −104.83, −130.76, and −196.29 μm. At 12 months, the mean changes in Early Treatment of Diabetic Retinopathy Study (ETDRS) letters were 6.38, 8.12, and 9.37, while the MT decrease was 126.51, 126.52, and 139.85 μm, respectively. However, statistically significant difference was only found between type 1 and 3 in vision improvement, both in the short term (p=0.0002) and long term (p=0.01). Conclusions. The reactivity to VEGF inhibitors varied among different subtypes of nAMD. The efficacy of intravitreal anti-VEGF therapy in type 3 nAMD was statistically better than type 1 when considering vision improvement at 3 and 12 months. Thus, the lesion subtype is a predictor for the treatment outcome which can help guide prognosis.

scholarly journals The Role of Mean Platelet Volume as a Predictor of Mortality in Critically Ill Patients: A Systematic Review and Meta-Analysis

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Pattraporn Tajarernmuang ◽  
Arintaya Phrommintikul ◽  
Atikun Limsukon ◽  
Chaicharn Pothirat ◽  
Kaweesak Chittawatanarat
Keyword(s):  
Systematic Review ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Mean Platelet Volume ◽  
Meta Analysis ◽  
Small Sample ◽  
Mean Difference ◽  
Platelet Volume ◽  
Significant Difference ◽  
The Mean

Background. An increase in the mean platelet volume (MPV) has been proposed as a novel prognostic indicator in critically ill patients.Objective. We conducted a systematic review and meta-analysis to determine whether there is an association between MPV and mortality in critically ill patients.Methods. We did electronic search in Medline, Scopus, and Embase up to November 2015.Results. Eleven observational studies, involving 3724 patients, were included. The values of initial MPV in nonsurvivors and survivors were not different, with the mean difference with 95% confident interval (95% CI) being 0.17 (95% CI: −0.04, 0.38;p=0.112). However, after small sample studies were excluded in sensitivity analysis, the pooling mean difference of MPV was 0.32 (95% CI: 0.04, 0.60;p=0.03). In addition, the MPV was observed to be significantly higher in nonsurvivor groups after the third day of admission. On the subgroup analysis, although patient types (sepsis or mixed ICU) and study type (prospective or retrospective study) did not show any significant difference between groups, the difference of MPV was significantly difference on the unit which had mortality up to 30%.Conclusions. Initial values of MPV might not be used as a prognostic marker of mortality in critically ill patients. Subsequent values of MPV after the 3rd day and the lower mortality rate unit might be useful. However, the heterogeneity between studies is high.

Diagnostic performance of optical coherence tomography angiography in glaucoma: a systematic review and meta-analysis

2019 ◽  
Vol 103 (11) ◽  
pp. 1677-1684 ◽  
Author(s):  
Ana I M Miguel ◽  
André B Silva ◽  
Luis F Azevedo
Keyword(s):  
Systematic Review ◽  
Optical Coherence Tomography ◽  
Prospective Studies ◽  
Diagnostic Performance ◽  
Optical Coherence Tomography Angiography ◽  
Meta Analysis ◽  
Optical Coherence ◽  
Manual Search ◽  
Significant Difference ◽  
The Mean

BackgroundCompared with current imaging methods, the diagnostic performance and the advantages and limitations of optical coherence tomography angiography (OCTA) remain unclear. We performed a systematic review and meta-analysis of studies investigating vessel density (VD) in patients with glaucoma using OCTA.MethodsWe conducted a literature search on PubMed, Scopus, Web of Science, ISI Conference Proceedings and Google Scholar, along with a manual search, from January 2006 to March 2018. We included prospective studies that used OCTA to compare the VD in glaucomatous eyes with healthy control eyes.ResultsOf 3045 screened articles, 24 were included in a broad characterisation and 18 in the meta-analysis. We observed a statistically significant reduction in the mean peripapillary VD (MPVD) in glaucoma (MPVD: 57.53%, 95% CI 52.60 to 62.46, p< 0.001) compared with controls (MPVD: 65.47%, 95% CI 59.82 to 71.11; standardised mean difference [SMD], –1.41, 95% CI –1.62 to –1.20, p< 0.001) for 888 glaucomatous and 475 healthy eyes, and also in the mean-whole optic nerve image VD (SMD, –9.63, 95% CI –10.22 to –9.03, p<0.001), mean inside-disc VD (SMD, − 9.51, 95% CI –12.66 to –6.36, p<0.05) and mean parafoveal VD (SMD, –3.92, 95% CI –4.73 to –3.12, p<0.001). Subgroup analyses revealed a significant difference in the MPVD across glaucoma subtypes and OCTA devices.ConclusionThis suggests the diagnostic utility of OCTA in detecting glaucomatous eyes; however, further longitudinal prospective studies are welcomed to characterise vascular changes in glaucoma.

scholarly journals Clinical Outcomes of the Traditional Latarjet Versus the Congruent Arc Modification for the Treatment of Recurrent Anterior Shoulder Instability: A Meta-analysis

2021 ◽  
Vol 9 (10) ◽  
pp. 232596712110302
Author(s):  
Sunita R.P. Mengers ◽  
Derrick M. Knapik ◽  
Matthew W. Kaufman ◽  
Gary Edwards ◽  
James E. Voos ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Outcomes ◽  
Shoulder Instability ◽  
Meta Analysis ◽  
Return To Sport ◽  
Late Complications ◽  
Anterior Shoulder Instability ◽  
Latarjet Procedure ◽  
Recurrent Instability

Background: Few studies have compared clinical outcomes between the traditional Latarjet procedure for anterior shoulder instability and the congruent arc modification to the Latarjet procedure. Purpose: To systematically evaluate the literature for the incidence of recurrent instability, clinical outcomes, radiographic findings, and complications for the traditional Latarjet procedure and the congruent arc modification and to compare results of each search. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review and meta-analysis was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. We included studies published between January 1990 and October 2020 that described clinical outcomes of the traditional Latarjet and the congruent arc modification with a follow-up range of 2 to 10 years. The difference in surgical technique was analyzed using a chi-square test for categorical variables, while continuous variables were evaluated using a Student t test. Results: In total, 26 studies met the inclusion criteria: 20 studies describing the traditional Latarjet procedure in 1412 shoulders, and 6 studies describing the congruent arc modification in 289 shoulders. No difference between procedures was found regarding patient age at surgery, follow-up time, Rowe or postoperative visual analog scores, early or late complications, return-to-sport timing, or incidence of improper graft placement or graft fracture. A significantly greater proportion of male patients underwent glenoid augmentation using the congruent arc modification versus traditional Latarjet ( P < .001). When comparing outcomes, the traditional Latarjet procedure demonstrated a lower incidence of fibrous union or nonunion ( P = .047) and broken, loose, or improperly placed screws ( P < .001), and the congruent arc modification demonstrated improved outcomes with regard to overall return to sport ( P < .001), return to sport at the same level ( P < .001), incidence of subluxation ( P = .003) or positive apprehension ( P = .002), and revision surgery for recurrent instability ( P = .027). Conclusion: Outcomes after the congruent arc modification proved at least equivalent to the traditional Latarjet procedure in terms of recurrent instability and return to sport, although early and late complications were equivalent. The congruent arc procedure may be an acceptable alternative to traditional Latarjet for the treatment of anterior shoulder instability with glenoid bone loss; however, long-term outcomes of this procedure are needed.

Outcomes of the Latarjet Procedure Versus Free Bone Block Procedures for Anterior Shoulder Instability: A Systematic Review and Meta-analysis

2020 ◽  
pp. 036354652092583
Author(s):  
Ron Gilat ◽  
Eric D. Haunschild ◽  
Ophelie Z. Lavoie-Gagne ◽  
Tracy M. Tauro ◽  
Derrick M. Knapik ◽  
...  
Keyword(s):  
Systematic Review ◽  
Shoulder Instability ◽  
Meta Analysis ◽  
Anterior Shoulder Instability ◽  
Bone Block ◽  
Return To Sports ◽  
Latarjet Procedure ◽  
Shoulder Stabilization ◽  
Recurrent Instability

Background: Free bone block (FBB) procedures for anterior shoulder instability have been proposed as an alternative to or bail-out for the Latarjet procedure. However, studies comparing the outcomes of these treatment modalities are limited. Purpose: To systematically review and perform a meta-analysis comparing the clinical outcomes of patients undergoing anterior shoulder stabilization with a Latarjet or FBB procedure. Study Design: Systematic review and meta-analysis; Level of evidence, 4. Methods: PubMed, Embase, and the Cochrane Library databases were systematically searched from inception to 2019 for human-participants studies published in the English language. The search was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement including studies reporting clinical outcomes of patients undergoing Latarjet or FBB procedures for anterior shoulder instability with minimum 2-year follow-up. Case reports and technique articles were excluded. Data were synthesized, and a random effects meta-analysis was performed to determine the proportions of recurrent instability, other complications, progression of osteoarthritis, return to sports, and patient-reported outcome (PRO) improvement. Results: A total of 2007 studies were screened; of these, 70 studies met the inclusion criteria and were included in the meta-analysis. These studies reported outcomes on a total of 4540 shoulders, of which 3917 were treated with a Latarjet procedure and 623 were treated with an FBB stabilization procedure. Weighted mean follow-up was 75.8 months (range, 24-420 months) for the Latarjet group and 92.3 months (range, 24-444 months) for the FBB group. No significant differences were found between the Latarjet and the FBB groups in the overall random pooled summary estimate of the rate of recurrent instability (5% vs 3%, respectively; P = .09), other complications (4% vs 5%, respectively; P = .892), progression of osteoarthritis (12% vs 4%, respectively; P = .077), and return to sports (73% vs 88%; respectively, P = .066). American Shoulder and Elbow Surgeons scores improved after both Latarjet and FBB, with a significantly greater increase after FBB procedures (10.44 for Latarjet vs 32.86 for FBB; P = .006). Other recorded PRO scores improved in all studies, with no significant difference between groups. Conclusion: Current evidence supports the safety and efficacy of both the Latarjet and FBB procedures for anterior shoulder stabilization in the presence of glenoid bone loss. We found no significant differences between the procedures in rates of recurrent instability, other complications, osteoarthritis progression, and return to sports. Significant improvement in PROs was demonstrated for both groups. Significant heterogeneity existed between studies on outcomes of the Latarjet and FBB procedures, warranting future high-quality, comparative studies.

Early Outcomes and Perioperative Complications of the Arthroscopic Latarjet Procedure: Systematic Review and Meta-analysis

2018 ◽  
Vol 47 (9) ◽  
pp. 2232-2241 ◽  
Author(s):  
Simone Cerciello ◽  
Katia Corona ◽  
Brent Joseph Morris ◽  
Domenico Alessandro Santagada ◽  
Giulio Maccauro
Keyword(s):  
Systematic Review ◽  
Revision Surgery ◽  
Meta Analysis ◽  
Complication Rates ◽  
Inclusion Criteria ◽  
Latarjet Procedure ◽  
Open Procedure ◽  
Arthroscopic Latarjet ◽  
Arthroscopic Latarjet Procedure ◽  
The Mean

Background: The arthroscopic Latarjet-Bristow procedure is emerging as a reliable alternative to the open procedure. The reduced soft tissue damage with potential advantages of early pain control and functional recovery is attractive. However, the operation is technically more demanding, and there are concerns regarding the potential for increased recurrence and complication rates. Purpose: To evaluate the available literature focusing on the reported functional outcomes and complications of the arthroscopic Latarjet procedure and compare them with the open procedure. Study Design: Systematic review and meta-analysis. Methods: A comprehensive systematic review was performed with the keywords “arthroscopy,” “arthroscopic,” “Latarjet,” and “Bristow,” with no limit regarding the year of publication. The review was limited to the English-language articles, and each article was evaluated with a modified MINORS (methodological index for nonrandomized studies) scoring system. Results: Fourteen studies met the inclusion criteria and were included in the review. Overall, 813 patients met inclusion criteria, with a mean follow-up of 24.5 months. The mean Walch-Duplay and Rowe scores were 89.6 and 90.2, respectively. The overall complication rate was 16.5%; intraoperative conversion to open surgery, 2%; recurrence, 2.5%; and revision surgery, 5.6%. When only comparative studies were considered, the overall complication rates were 23.7% (arthroscopically) and 15.3% (open). The recurrence and revision surgery rates were 6.5% and 5.7% in the study group, while the corresponding values in the control group were 4% and 2.9%. The mean MINORS score was 14.5 (11.6 for noncomparative studies and 19 for comparative studies). Conclusion: The arthroscopic Latarjet-Bristow procedure is reliable. Outcomes are satisfactory, with less pain and faster recovery in the first postoperative week. However, the procedure is technically demanding, and higher rates of complications and reoperations should be expected. Finally, the arthroscopic operation is much more expensive in terms of implanted materials than the open procedure.

Open Versus Arthroscopic Latarjet Procedure for Anterior Shoulder Instability: A Systematic Review and Meta-analysis

2018 ◽  
Vol 47 (5) ◽  
pp. 1248-1253 ◽  
Author(s):  
Eoghan T. Hurley ◽  
Daren Lim Fat ◽  
Shane K. Farrington ◽  
Hannan Mullett
Keyword(s):  
Systematic Review ◽  
Learning Curve ◽  
Shoulder Instability ◽  
Meta Analysis ◽  
Anterior Shoulder Instability ◽  
Latarjet Procedure ◽  
Recurrent Instability ◽  
Arthroscopic Procedure ◽  
Arthroscopic Latarjet ◽  
Arthroscopic Latarjet Procedure

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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