Increased Risk of Short-Term Complications and Venous Thromboembolism in Latarjet-Bristow Procedures Compared With Bankart Repairs.

PURPOSE: To (1) determine the rate of surgical complications and venous thromboembolism (VTE) in patients undergoing arthroscopic Bankart repair, open Bankart repair, or Latarjet-Bristow; and (2) assess potential risk factors for surgical complications and VTE in patients undergoing shoulder stabilization procedures. METHODS: The NSQIP database was used to identify patients undergoing isolated surgery for shoulder instability from 2005 to 2017. Demographic data were collected and compared. Logistic regression was used 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. RESULTS: We identified 7,233 patients for inclusion. Patients undergoing Latarjet-Bristow were more likely to be male and Black and to report current tobacco use. Overall, there was a low rate of surgical complications (0.4%) and VTE (0.2%). However, patients undergoing Latarjet-Bristow had nearly a 10-fold increase in the risk of surgical complications compared with an arthroscopic or open Bankart repair (1.9% versus 0.2%, P < .001), including deep surgical site infections, return to operating room within 30 days, and symptomatic VTE (deep venous thrombosis rate: arthroscopic Bankart repair, 0.1%; Latarjet-Bristow, 0.8%; P < .001). There were no differences in the odds of developing a surgical complication or VTE between patients undergoing arthroscopic or open Bankart repair. CONCLUSION: 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. 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. LEVEL OF EVIDENCE: III, retrospective comparative trial.

Increased radiodensity of the proximal pole of the scaphoid: a common finding in computed tomography imaging of the wrist.

OBJECTIVES: To determine whether the proximal pole (PP) of the scaphoid is denser than the distal pole (DP) in a diverse population of patients undergoing computed tomography (CT) imaging of the wrist. METHODS: Sixty-nine patients who had CT of the wrist were retrospective reviewed. We measured CT density of the medullary bone of PP and DP of the scaphoid and calculated PP/DP ratio. To evaluate the variability of PP/DP ratio, we compared the ratios of these 3 groups. These patients were separated into 3 groups based on their diagnoses: group 1, healed scaphoids treated by casting; group 2, scaphoid nonunions; group 3, intact scaphoids. RESULTS: Proximal pole was denser than DP in most subjects. Proximal pole/distal pole ratio was similar among groups (P < 0.05). Fracture healing, sex, and age did not affect this ratio. However, we did not study scaphoids with avascular necrosis. CONCLUSIONS: Proximal pole was denser than DP in most of our subjects, including those with intact scaphoids, healing scaphoid fractures, and nonunions.