title: Is the Latarjet procedure risky? Analysis of complications and learning curve.
abstract: OBJECTIVE
  The purpose of this study was to analyse the learning curve and complication rate of the open Latarjet procedure.
  
  
  METHODS
  The first 68 Latarjet procedures performed by a single surgeon for chronic anterior shoulder instability were reviewed retrospectively. The standard open surgical technique was followed faithfully during each procedure. Post-operative complications were taken from patient medical records. Post-operative evaluation consisted of clinical and radiological assessments.
  
  
  RESULTS
  The rate of early (<3 months) clinical complications was 7.4 % (5.9 % haematoma, 1.5 % neurological deficit), and the delayed complication rate was 7.3 %. Early complication rate, duration of surgery (mean 65 min; 35-135) and hospital stay (mean 3 days; 1-4) were significantly reduced as experience increased (respectively; P = 0.03, ρ = - 0.3; P = 0.009, ρ = - 0.3; P < 0.0001, ρ = - 0.6). On the radiographs, the bone block was healed and in perfect position in 87 % of cases, with no effect of surgical experience (P = 0.3, ρ = 0.1). The rate of complications on radiographs was 17 %: 11 % partial lysis, 2 % complete lysis and 4 % non-union. No recurrence of instability was found after an average follow-up of 21 months.
  
  
  CONCLUSIONS
  Despite a high rate of post-operative complications, the morbidity of Latarjet procedure remains low. A surgeon's experience significantly affects the surgery duration and the occurrence of early complications. The main radiological complication is partial lysis of the bone block. After a short learning curve, the clinical outcomes of the Latarjet procedure appear to be satisfactory and reproducible.
  
  
  METHODS
  IV.
authors.affiliation: Département de chirurgie Orthopédique, Hôpital Riquet, CHU de Toulouse, Place Baylac, 31059, Toulouse, France.
authors.forename: Florence
authors.initials: F
authors.lastname: Dauzère
authors.affiliation: Département de chirurgie Orthopédique, Hôpital Riquet, CHU de Toulouse, Place Baylac, 31059, Toulouse, France.
authors.forename: Amélie
authors.initials: A
authors.lastname: Faraud
authors.affiliation: Département de chirurgie Orthopédique, Hôpital Riquet, CHU de Toulouse, Place Baylac, 31059, Toulouse, France.
authors.forename: Julie
authors.initials: J
authors.lastname: Lebon
authors.affiliation: Service de Radiologie, Hôpital Riquet, CHU de Toulouse, Place Baylac, 31059, Toulouse, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Faruch
authors.affiliation: Département de chirurgie Orthopédique, Hôpital Riquet, CHU de Toulouse, Place Baylac, 31059, Toulouse, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Mansat
authors.affiliation: Département de chirurgie Orthopédique, Hôpital Riquet, CHU de Toulouse, Place Baylac, 31059, Toulouse, France. nicolasbonnevialle@yahoo.fr.|Laboratoire de Biomécanique, IMFT CNRS UMR 5502, Hôpital Riquet, Place Baylac, 31059, Toulouse, France. nicolasbonnevialle@yahoo.fr.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Bonnevialle
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000601:surgery*; D059032:Learning Curve; D008297:Male; D019637:Orthopedic Procedures / Q000009:adverse effects* / Q000706:statistics & numerical data; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D012783:Shoulder Dislocation / Q000601:surgery*; D012785:Shoulder Joint / Q000601:surgery*; D055815:Young Adult
keywords: Anterior instability; Bone block; Complication; Latarjet; Learning curve; Osteolysis; Shoulder