BACKGROUND This study aimed to investigate the short-term complications (minimum 1-year follow-up) after either an arthroscopic Bristow or Latarjet procedure for anterior shoulder instability utilizing screw or suture-button fixation. METHODS Patients undergoing arthroscopic Bristow or Latarjet procedures between November 2016 and April 2021 were enrolled. Data were collected at baseline, 3 months, 6 months, and every year after surgery. Risks of postoperative complications and unplanned reoperations were assessed. A multivariable regression model was used to identify risk factors for complications and to determine the association of complications with patient-reported outcomes. RESULTS A total of 412 patients (425 shoulders) undergoing arthroscopic Bristow or Latarjet procedures performed by a single surgeon between November 2016 and April 2021 were reviewed. Two hundred and ninety-nine patients (308 shoulders, 76.2% of 404 eligible) with a mean follow-up of 22.3 ± 4.2 months were included for analysis. Two hundred and sixty-nine shoulders (87.3%) underwent a Bristow procedure (165 with screw and 104 with suture-button fixation), while 39 (12.7%) underwent a Latarjet procedure (18 with screw and 21 with suture-button fixation). Eighty-two patients (83 shoulders) reported a total of 85 complications within 2 years after surgery, with an overall complication rate of 26.9%. The rates of recurrent dislocation or subluxation and infection were 1.9% and 0.6%, respectively, while a total of 4 (1.3%) of the shoulders had unplanned reoperations. The most common complications were graft-related (11.7%), followed by complications involving neurologic symptoms (10.7%). The overall, graft, and neurologic complication rates following Bristow or Latarjet procedures were 27.1% versus 25.6%, 12.3% versus 7.7%, and 10.0% versus 15.4%, respectively. Compared with the Bristow technique with screw fixation, Bristow with suture-button fixation yielded a lower risk of any complications (odds ratio [OR], 0.55; p = 0.04). Paying with rural insurance and poor sleep quality prior to surgery were associated with increased risk of any complications. CONCLUSIONS Compared with arthroscopic Bristow procedures with screw fixation, Bristow procedures with suture-button fixation resulted in a lower overall complication risk. Both patient demographic and implant-specific factors were associated with the development of a complication. LEVEL OF EVIDENCE Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.

中文翻译：

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螺钉固定与纽扣固定的关节镜 Bristow 或 Latarjet 手术的短期并发症：单个外科医生对 308 例连续病例的前瞻性研究。


背景本研究旨在调查采用螺钉或缝线纽扣固定的关节镜 Bristow 或 Latarjet 手术治疗肩前不稳定后的短期并发症（至少 1 年随访）。方法 2016 年 11 月至 2021 年 4 月期间接受关节镜 Bristow 或 Latarjet 手术的患者纳入研究。在基线、手术后 3 个月、6 个月和每年收集数据。评估术后并发症和计划外再次手术的风险。使用多变量回归模型来识别并发症的危险因素并确定并发症与患者报告的结果的关联。结果 2016 年 11 月至 2021 年 4 月期间，共有 412 名患者（425 个肩膀）接受了由一名外科医生进行的关节镜 Bristow 或 Latarjet 手术。平均随访时间为 22.3 ± 4.2 个月的 299 名患者（308 名肩膀，404 名合格患者中的 76.2%）被纳入分析。 269 例肩部 (87.3%) 接受了 Bristow 手术（165 例采用螺钉固定，104 例采用纽扣固定），而 39 例肩部 (12.7%) 接受了 Latarjet 手术（18 例采用螺钉固定，21 例采用纽扣固定） 。 82 例患者（83 肩）术后 2 年内共报告 85 例并发症，总并发症率为 26.9%。复发性脱位或半脱位和感染率分别为 1.9% 和 0.6%，共有 4 例（1.3%）肩部进行了计划外再次手术。最常见的并发症是移植相关的（11.7%），其次是涉及神经系统症状的并发症（10.7%）。 Bristow 或 Latarjet 手术后的总体并发症发生率、移植并发症发生率和神经系统并发症发生率为 27。分别为 1% 与 25.6%、12.3% 与 7.7% 以及 10.0% 与 15.4%。与采用螺钉固定的 Bristow 技术相比，采用纽扣固定的 Bristow 技术发生任何并发症的风险较低（比值比 [OR]，0.55；p = 0.04）。使用农村保险支付和手术前睡眠质量差与任何并发症的风险增加有关。结论 与螺钉固定的关节镜 Bristow 手术相比，纽扣固定的 Bristow 手术总体并发症风险较低。患者人口统计和种植体特异性因素都与并发症的发生有关。证据级别 治疗级别 II。有关证据级别的完整描述，请参阅作者须知。