Latarjet-Bristow Linked to More Risk Than Bankart Repair

Patients who undergo a Latarjet-Bristow procedure are at a higher risk for short-term postoperative complications than those undergoing Bankart repair, according to a new study appearing in the March 2021 edition of the Arthroscopy Journal.

In the study, “Increased Risk of Short-Term Complications and Venous Thromboembolism in Latarjet-Bristow Procedures Compared With Bankart Repairs,” the researchers sought to determine the rate of surgical complications and venous thromboembolism (VTE) in patients undergoing arthroscopic Bankart repair, open Bankart repair or Latarjet-Bristow.

The researchers also sought to evaluate potential risk factors for surgical complications and VTE in patients undergoing shoulder stabilization procedures. They used logistic regression to assess the risk factors for developing a postoperative complication, and regression analyses were used to evaluate the odds of postoperative complications between types of surgery.

Using the National Surgical Quality Improvement Program (NSQIP) database, the researchers identified 7,233 patients who had surgery for shoulder instability from 2005 to 2017. Overall, patients undergoing Latarjet-Bristow were more likely to be male and Black and to report current tobacco use.

There was a low rate of surgical complications (0.4%) and VTE (0.2%), however, patients undergoing Latarjet-Bristow had almost 10 times the risk of surgical complications compared with an arthroscopic or open Bankart repair (1.9% versus .02%; p < .001), including deep surgical site infections, return to operating room within 30 days, and symptomatic VTE (deep vein thrombosis rate: arthroscopic Bankart repair, 0.1%; Latarjet-Bristow, 0.8%; p < .001).

The researchers also found no differences in the odds of developing a surgical complication or VTE between patients undergoing arthroscopic or open Bankart repair.

“This study used a nationally representative, widely validated, peer-reviewed database to demonstrate that patients undergoing a Latarjet-Bristow procedure are at significantly higher risk for short-term postoperative complications, including deep surgical site infections, return to the operating room, and symptomatic VTE, than those undergoing Bankart repair,” the researchers wrote.

“These findings should not discourage surgeons from proceeding with a coracoid transfer procedure when indicated for glenoid deficiencies but should inform preoperative counseling and help guide perioperative care to optimize patient outcomes.”