What Is the Trajectory of Recovery in the Early Postoperative Period after the Big 3 Shoulder Surgeries? Comparative Analysis Using 3 Previous Prospective Studies.

(1) Background: The aims of this study were to compare serial changes in outcome measures in the early postoperative period after rotator cuff repair (RCR), anatomical total shoulder replacement (ATSR), and reverse total shoulder replacement (RTSR). (2) Methods: In total, 143 patients who underwent RCR (n = 47), ATSR (n = 46), and RTSR (n = 50) were included. The visual analogue scale (VAS) for pain, the activity of daily living (ADL) score, and the American Shoulder and Elbow Surgeons (ASES) score were completed. (3) Results: At 3 months, the recovery rate for the VAS pain score was 43.7% in the RCR, 89.1% in the ATSR, and 78.4% in RTSR. The recovery rate for the ADL score was 36.3%, 69.5%, and 76.4%. The recovery rate for ASES score was 40.9%, 79.5%, and 77.4%. For all outcome measures, a lower recovery rate was observed in the RCR group than in the ATSR and RTSR groups. At 6 months after surgery, the recovery rate for the VAS pain score was 69.9%, 100%, and 90.3%. The recovery rate for the ADL score was 66.8%, 92.8%, and 91.5%. The recovery rate for the ASES score was 68.7%, 96.5%, and 90.9%. (4) Conclusion: Compared with ATSR and RTSR, a slower recovery rate was observed for RCR, measured to be approximately 40% at 3 months and 70% at 6 months after surgery. Rapid improvement in pain and shoulder function was achieved after ATSR and RTSR, with a recovery rate of over 70% at 3 months and over 90% at 6 months after surgery.

Nanofiber Graft Therapy to Prevent Shoulder Stiffness and Adhesions after Rotator Cuff Tendon Repair: A Comprehensive Review.

Stiffness and adhesions following rotator cuff tears (RCTs) are common complications that negatively affect surgical outcomes and impede healing, thereby increasing the risk of morbidity and failure of surgical interventions. Tissue engineering, particularly through the use of nanofiber scaffolds, has emerged as a promising regenerative medicine strategy to address these complications. This review critically assesses the efficacy and limitations of nanofiber-based methods in promoting rotator cuff (RC) regeneration and managing postrepair stiffness and adhesions. It also discusses the need for a multidisciplinary approach to advance this field and highlights important considerations for future clinical trials.

Effect of Gabapentin on Tendon-to-Bone Healing in a Rat Model of Rotator Cuff Repair.

BACKGROUND: Gabapentin is often used as an analgesic after rotator cuff repair surgery and is recommended as an additional analgesic for arthroscopic rotator cuff repairs. However, evidence of its effects on biological healing mechanisms is lacking. The objective of this study was to investigate the potential of gabapentin in improving tendon-to-bone healing after rotator cuff repair using a rat model. MATERIALS AND METHODS: A total of 20 male rats were randomly allocated to one of two groups: group 1 (repair only, n=10) or group 2 (gabapentin injection, n=10). The rats in the experimental group (group 2) were administered 80 mg/kg of gabapentin subcutaneously 30 minutes before surgery, followed by 80 mg/kg subcutaneously every 24 hours for 48 hours. We used the left shoulder of every rat, while for biomechanical analysis, we used the right shoulder. RESULTS: There was no significant difference in the load to failure, ultimate stress, or elongation between the groups. Collagen continuity, orientation, and density were better in group 2 than group 1. CONCLUSION: In a rat model of rotator cuff repair, gabapentin had a positive impact on the quality of collagen organization at the junction between the tendon and bone, while preserving the biomechanical properties. We propose the use of gabapentin as a supplementary analgesic agent for postoperative pain relief after arthroscopic rotator cuff repair; however, further studies of the effect of gabapentin on biological healing mechanisms are required. [Orthopedics. 202x;4x(x):xx-xx.].

Does prior rotator cuff surgery influence the outcomes and complications after reverse total shoulder arthroplasty in patients with cuff tear arthropathy or massive rotator cuff tear? A propensity score-matched study.

BACKGROUND: The aim of this study was to compare outcomes and complications in patients with and without a history of prior rotator cuff surgery who underwent reverse total shoulder arthroplasty (RTSA). METHODS: Two-hundred and nine consecutive patients who had undergone RTSA for rotator cuff insufficiency with a minimum 12-months follow-up period were reviewed. A total of 35 patients with a history of prior rotator cuff surgery were made the study group (PS group). Using propensity score matching for age and sex, these patients were matched 1:3 with a control group of 105 patients with no history of prior surgery (NPS group). The mean follow-up period was 41.4 months. RESULTS: Both groups showed a significant improvement of clinical scores and range of motion after RTSA. The PS group showed a significantly higher final visual analog scale (VAS) pain score compared with the NPS group (P = 0.020). The PS group showed a significantly higher incidence of acromial stress fracture compared with the NPS group (17.1% vs 4.8%, P = 0.018), but no significant difference in the overall complication rate was observed (25.7% vs 13.3%, P > 0.05). The PS group showed a significantly higher reoperation rate compared with the NPS group (14.3% vs 1.9%, P = 0.004). CONCLUSIONS: Our study demonstrated that a history of prior rotator cuff surgery was associated with a high incidence of acromial stress fracture and reoperation after RTSA as well as a high final VAS pain score, although satisfactory clinical outcomes after RTSA were achieved in both groups.

Pure varus posteromedial rotatory instability of the elbow: Radiographic findings, treatment, and outcomes.

INTRODUCTION: Although varus posteromedial rotatory instability (VPMRI) is a subtle elbow injury that involves anteromedial coronoid facet (AMCF) fracture and ligamentous injuries, treatment options and outcomes of VPMRI remains controversial. The aim of this study was to investigate radiographic findings, treatments, and outcomes of a large series of VPMRI. METHODS: We retrospectively reviewed 91 pure VPMRI cases with AMCF fracture (O'Driscoll classification anteromedial type) which were treated at 6 hospitals. Clinical and radiographic outcomes were investigated with a mean follow-up period of 46.8 months using the Mayo elbow performance score (MEPS), and the Quick Disabilities of the Arm, Shoulder and Hand (Quick-DASH) score, and serial plain radiographs. RESULTS: In AMCF fracture, there were 4 cases of subtype 1, 67 cases of subtype 2, and 20 cases of subtype 3. On MRI, complete tears of lateral collateral ligament and medial collateral ligament were observed in 83.1 % (59/71 cases) and 33.8 % (24/71 cases). Operative treatment was performed in 68 cases (74.7 %) including both side fixation in 40 cases (58.8 %), medial side fixation only in 17 cases (25.0 %), and lateral side fixation only in 11 cases (16.2 %). Nonoperative treatment was performed in 23 cases (25.3 %). The mean final MEPS and Quick-DASH scores were 93.7 and 7.9. The overall complication and reoperation rates were 22.0 % and 15.4 %. No significant differences regarding final clinical scores and range of motions were observed between the operative group and the nonoperative group, but significant differences were observed regarding number (p = 0.019) and displacement (p = 0.002) of coronoid fragment, and complication rate (p < 0.001) between the two groups. CONCLUSION: Depending on the pattern of coronoid fragment and the degree of ligamentous injuries, operative treatment of unstable VPMRI using various fixation techniques including coronoid fixation and ligament repair yielded satisfactory final clinical outcomes. However, surgeons should be aware of the high complication and reoperation rates after operative treatment. Stable VPMRI with AMCF fracture involving minimal displacement or small number of fragments can be treated nonoperatively.

MMP-1 and MMP-9 are Highly Expressed in the Joint Capsule of Diabetic Frozen Shoulder.

BACKGROUND: The pathophysiology of frozen shoulder (FS) involves abnormal expressions of matrix metalloproteinases (MMPs) and tissue inhibitor of metalloproteinases (TIMPs) that lead capsular fibrosis. However, there has been little concern for why diabetic FS has more protracted fibrotic condition. The objective of this study was to compare the expression levels of MMPs and TIMPs in the joint capsule of patients with diabetic and non-diabetic FS. MATERIALS AND METHODS: Samples of capsular tissue were collected from 20 patients with FS (10 diabetic patients; diabetic group, and 10 non-diabetic patients; non-diabetic group) and 10 patients (control group) with chronic anterior shoulder instability. Quantitative real-time RT-PCR and Western blot analysis were performed to determine the expression levels of mRNA and protein for MMP-1, 3, 9, 13, 14, and TIMP-1, 2. RESULTS: The results of quantitative real-time RT-PCR showed significantly higher expression levels of all MMPs and TIMP-1 and significantly lower expression levels of TIMP-2 in the joint capsule of patients in the diabetic or non-diabetic groups compared with the control group. Significantly higher expression levels of MMP-1, 9, 14, and TIMP-1 were detected in the diabetic group compared with the non-diabetic group. The results of Western blot analysis showed significantly higher levels of MMP-3, 13, 14, and TIMP-1 in the joint capsule of patients in the diabetic or non-diabetic groups compared with the control group. However, no significant differences of protein levels of them were observed between diabetic and non-diabetic groups. CONCLUSIONS: The findings of this study demonstrate the potential involvement of MMP-1 and 9 in the pathophysiology of diabetic FS. These findings may be helpful in identification of therapeutic targets for development of novel treatments for this protracted chronic fibrosing condition.

Rotator Cuff Muscle Imbalance in Patients with Chronic Anterior Shoulder Instability.

(1) Background: Both intra-articular pathologies and muscle imbalance can be a cause of shoulder instability. The purpose of this study is to examine the cross-sectional areas of the rotator cuff muscle in patients with acute and chronic anterior shoulder instability and to determine the associations between imbalance and chronicity of the rotator cuff. (2) Methods: Patients with confirmed dislocation of the anterior shoulder were included. The patients were divided into two groups according to the time between the initial dislocation event and when MRI imaging was performed Measurements of the rotator cuff muscle areas were performed in the scapular Y view and glenoid face view using MRI. (3) Results: A total of 56 patients were enrolled. In the Y view, a larger area of supraspinatus muscle was observed in the chronic group compared with the acute group (17.2 ± 2.3% vs. 15.6 ± 2.2%, p = 0.006). However, a smaller area of subscapularis muscle was observed in the chronic group (47.1 ± 3.5% vs. 49.6 ± 5.3%, p = 0.044). Using the glenoid face view, a larger area of supraspinatus muscle was observed in the chronic group than in the acute group (18.5 ± 2.5% vs. 15.8 ± 2.2%, p < 0.001). However, a smaller area of subscapularis muscle was observed in the chronic group (41.6 ± 3.2% vs. 45.6 ± 4.4%, p < 0.001). (4) Conclusion: Larger areas of supraspinatus muscle compared with acute instability were observed in patients with chronic anterior shoulder instability. In contrast, a smaller area of subscapularis muscle was observed in the chronic group.

Bilateral snapping triceps syndrome: A case report.

BACKGROUND: Snapping triceps syndrome (STS) is a rare disease, while occurrence of bilateral STS is extremely rare. It is usually accompanied by dislocation of the ulnar nerve and double snapping is a clinically important feature. However, to the best of our knowledge, there has been no report of bilateral STS in young active patient. CASE SUMMARY: A 23-year-old male presented with a complaint of discomfort and snapping on the medial side of both elbows while performing push-ups. On physical examination, two distinct snaps that were both palpable and audible were detected on additional clinical examination. Dynamic ultrasonography showed that the ulnar nerve and the medial head of the triceps were dislocated anteriorly over the medial epicondyle of the elbow during flexion motion. Finally, he was diagnosed as dislocation of the ulnar nerve and STS. Staged anterior subcutaneous transposition of the ulnar nerve combined with partial resection of the snapping portion of the triceps was performed. The patient's pain and snapping symptoms were resolved immediately after surgery. Three months later, the patient was completely asymptomatic and returned to normal activity. CONCLUSION: STS should be included in the differential diagnosis for active young patients who present with painful snapping on the medial side of the elbow joint, particularly when dislocation of the ulnar nerve is detected. Dynamic sonography is used to assist in accurate diagnosis and differentiation between isolated dislocation of the ulnar nerve and STS.

Outcomes and complications after treatment for anteromedial facet fracture of the coronoid process: A systematic review.

BACKGROUND: Fracture of the anteromedial facet (AMF) of the coronoid process is associated with varus posteromedial rotatory instability (VPMRI). However, there is still controversy regarding the optimal treatment for AMF fracture. The purpose of this study is to report on a systematic review of the outcomes and complications after treatment for AMF fracture. METHODS: This study was conducted using electronic databases, PubMed, EMBASE and Scopus. Studies reporting outcome scores and complications were included. Studies that did not utilize O'Driscoll classification for AMF fractures were excluded. Through conduct of a thorough review of included studies, definite VPMRI were identified and cases involving other injury mechanisms were excluded. RESULTS: Fifteen articles reporting on 246 patients were included. According to O'Driscoll classification, 6.2% of cases were anteromedial subtype I, 73.7% were subtype II, and 20.1% were subtype III. Two-hundred sixteen patients (87.8%) were treated surgically and 30 patients (12.2%) were treated conservatively. Lateral collateral ligament (LCL) injuries were 76.2% (157/206) and medial collateral ligament injuries were 16.9% (33/195). Among 216 cases who underwent surgical treatment, depending on the fragment size, displacement, and instability, coronoid fixation was performed in 189 cases and LCL repair alone was performed in 27 cases. The mean final Mayo Elbow Performance Score was 92.1 and the Broberg & Morrey score was 89.5. The overall complication and reoperation rates were 17.7% (41/232) and 12.9% (26/202). CONCLUSIONS: Both surgical and conservative treatment for AMF fractures resulted in satisfactory final clinical outcomes. However, high complication and reoperation rates were observed.

Bilateral dislocation of the long head of biceps tendon with intact rotator cuff tendon: A case report.

BACKGROUND: Dislocation of the long head of biceps tendon (LHBT) usually involves rotator cuff injury, and isolated dislocation with an intact rotator cuff is rare. Some cases of isolated dislocation have been reported. However, to the best of our knowledge, there has been no report of bilateral dislocation of the LHBT without rotator cuff pathology. CASE SUMMARY: A 23-year-old male presented to our outpatient clinic with left side dominant pain in both shoulders. The patient had no history of trauma or overuse. The patient underwent intra-articular injection and physical therapy, but his symptoms aggravated. Based on preoperative imaging, the diagnosis was bilateral dislocation of the LHBT. Dysplasia of the bicipital groove was detected in both shoulders. Active dislocation of the biceps tendon over an intact subscapularis tendon was identified by diagnostic arthroscopy. Staged biceps tenodesis was performed and continuous passive motion therapy was administered immediately after surgery. The patient's pain was resolved, and full functional recovery was achieved, and he was satisfied with the condition of his shoulders. CONCLUSION: This study describes a rare case of bilateral dislocations of the LHBT without rotator cuff injury due to dysplasia of the bicipital groove.

Clinical Outcomes Following Arthroscopic Decompression and Repair versus Repair Alone in Patients with a Concomitant Spinoglenoid Cyst and SLAP Lesion: A Systematic Review.

(1) Background: Patients with a superior-labrum-from-anterior-to-posterior (SLAP) tear associated with a spinoglenoid ganglion cyst have undergone various procedures. The purpose of this study is to evaluate clinical outcomes following arthroscopic treatment in patients with a concomitant spinoglenoid ganglion cyst and SLAP lesion. (2) Methods: This study followed PRISMA (preferred reporting items for systematic reviews and meta-analyses) guidelines, utilizing the PubMed, EMBASE, Cochrane Library, and Scopus databases. The keywords included shoulder, SLAP, labral tear, spinoglenoid notch, paralabral cyst, arthroscopy, and treatment. (3) Results: A total of 14 articles (206 patients) were included. Repair alone was administered in 114 patients (Group R), and 92 patients underwent additional cyst decompression (Group RD). Both groups showed excellent and similar clinical scores. The rate of the complete resorption of the cyst was 95.5% in Group RD, and 92.2% in Group R. The complication rate was 3.5% in Group RD, and 11.4% in Group R. The reoperation rate was 0% in Group RD, and 5.3% in Group R. (4) Conclusion: Reliable clinical outcomes without serious complications were obtained from the use of both procedures. The decompression of the cyst is a safe method that will alleviate pressure on the suprascapular nerve.

Posterior Medial Meniscus Root Repair Using Two Transtibial Tunnels with Modified Mason-Allen Stitches: A Technical Note.

Complete tear of the posterior medial meniscus root can result in a loss of hoop tension and increased contact pressure. Thus, medial meniscus posterior root tear (MMPRT) is increasingly recognized as an important pathology. Although several surgical techniques for MMPRT have recently been introduced, the ideal technique is not yet established. This technical note is aimed at introducing a novel surgical technique using two transtibial tunnels with modified Mason-Allen stitches in the treatment of MMPRT.

Correlation of Y Balance with Clinical Scores and Functional Tests after Anterior Cruciate Ligament Reconstruction in Young and Middle-Aged Patients.

Background: Criteria for return to sports (RTS) following anterior cruciate ligament (ACL) reconstruction have been extensively studied. But there is no consensus among investigators regarding which factors are most important in determining a safe RTS. Methods: Sixty-one patients who underwent ACL reconstruction were included. Subjective knee scoring systems (International Knee Documentation Committee [IKDC] score and Lysholm score), functional performance tests (carioca test and single-leg hop for distance [SLHD] test), and isokinetic knee strength test were used for assessment and analyzed for association with the limb symmetry index (LSI) of the Y-balance test for lower quarter (YBT-LQ). Results: The LSI of the YBT-LQ was significantly correlated with Lysholm score, IKDC score, Carioca, LSI for the SLHD, and extensor strength deficit at 6 months after ACL reconstruction. At 12 months, Lysholm score, IKDC score, LSI for the SLHD, and extensor strength deficit were significantly correlated with the LSI of the YBT-LQ. Conclusions: The YBT-LQ test could be used conveniently as an additional tool to assess the patient's functional performance results after ACL reconstruction in outpatient clinics.

Is Routine Screening Using Duplex Ultrasonography for Deep Vein Thrombosis Necessary after Shoulder Arthroplasty?

The aims of this study were to examine the incidence, risk factors, and outcomes of deep vein thrombosis (DVT) after shoulder arthroplasty in Korean patients. A total of 265 patients who underwent shoulder arthroplasty were included. The mean age of the patients was 74.6 years, and there were 195 females and 70 males. Clinical data including patient demographics, blood tests, and previous and current medical history were investigated. For screening of DVT, duplex ultrasonography of the operative arm was performed 2 to 5 days after surgery. Of the 265 patients, 10 patients (3.8%) were diagnosed with DVT using postoperative duplex ultrasonography. There were no cases of pulmonary embolism. There were no significant differences between the DVT and no DVT groups regarding all clinical data, except for the Charlson comorbidity index (CCI), which was significantly higher in the DVT group than in the no DVT group (5.0 vs. 4.1; p = 0.029). All patients had asymptomatic DVT that showed complete resolution after administration of antithrombotic agents or close observation without medications. The overall incidence of DVT was 3.8% during a period of 3 months after shoulder arthroplasty in Korean patients, and most cases were asymptomatic. Routine screening for DVT using duplex ultrasonography after shoulder arthroplasty may not be necessary except in patients with high CCI.

Long-term outcomes after humeral head replacement and total shoulder replacement for osteonecrosis of the humeral head: a mean follow-up of 8 years.

INTRODUCTION: The purpose of this study was to compare the outcomes and complications after humeral head replacement (HHR) and total shoulder replacement (TSR) in patients with osteonecrosis of the humeral head (ONHH). MATERIALS AND METHODS: Twenty-six patients who underwent shoulder replacement (13 HHRs and 13 TSRs) for nontraumatic ONHH were included. The mean follow-up period was 96.4 months. The visual analog scale (VAS) pain score, the University of California at Los Angeles (UCLA) score, the American Shoulder and Elbow Surgeon (ASES) score, and range of motion (ROM) at the final follow-up evaluation were used for the assessment of clinical outcomes. RESULTS: The mean VAS pain score, UCLA score, and ASES score showed significant improvement from 6.3, 11.6, and 35.0 before surgery to 2.2, 28.9, and 82.6 at the final follow-up evaluation (all p < 0.001). No significant differences regarding all clinical scores and ROMs were observed between the HHR group and the TSR group, except that a greater abduction angle was observed in the HHR group compared with the TSR group (123.1° versus 96.9°, p = 0.014). Two patients in the TSR group underwent multiple reoperations due to periprosthetic joint infection. No revision surgeries were performed for glenoid erosion following HHR or aseptic glenoid loosening following TSR. CONCLUSIONS: The findings of this study showed satisfactory clinical and radiological outcomes with implant longevity for both HHR and TSR in patients with nontraumatic ONHH. The HHR group had a greater abduction angle compared with the TSR group.

Outcomes and complications after arthroplasty in patients with osteonecrosis of humeral head- systematic review.

BACKGROUND: The purpose of this study was to investigate the outcomes and complications of hemiarthroplasty (HA) and total shoulder arthroplasty (TSA) in patients of osteonecrosis of humeral head (ONHH) through systematic review. METHODS: PRISMA (Preferred Reporting Items for Systematic Meta-Analyses) guidelines were followed by utilizing the PubMed, EMBASE, Scopus, Ovid, and Cochrane Library databases. Keywords included ONHH, avascular necrosis, head replacement, hemiarthroplasty, or total shoulder arthroplasty. Methodological Index for Nonrandomized Studies (MINORS) was used for quality assessment. RESULTS: Ten studies (416 shoulders) were finally eligible and mean MINORS score was 11.9 (ranges, 8-16). HA was performed in 255 shoulders (61.3%) and TSA in 161 (38.7%). Mean age of the patients at the time of surgery was 50.6 years and mean follow-up period was 73.1 months. All clinical scores with range of motion were significantly improved after surgery. Overall complication rate was 20.0% with 10.1% in HA and 17.5% in TSA (p = 0.077). Overall reoperation rate was 11.2% with 7.0% in HA and 15.0% in TSA (p = 0.046). Overall revision rate was 6.4% with 5.7% in HA and 9.2% in TSA (p = 0.349). CONCLUSIONS: Both HA and TSA in patients with ONHH yielded functional improvement with pain relief, but TSA had higher reoperation rate compared to HA.

Does reverse shoulder arthroplasty improve emotional status and quality of life in patients with rotator cuff insufficiency? Prospective sequential follow-up study.

BACKGROUND: The purpose of this study was to investigate sequential changes of emotional status and quality of life after reverse shoulder arthroplasty (RSA) for rotator cuff insufficiency and to determine the predictors that can affect postoperative clinical outcomes. This study was conducted to prove the hypothesis that RSA would improve emotional status and quality of life. METHODS: Fifty patients undergoing RSA for rotator cuff insufficiency were prospectively included. Evaluation using the visual analog scale pain score, American Shoulder and Elbow Surgeons (ASES) score, subjective shoulder value, Hospital Anxiety and Depression Scale (HADS), and Abbreviated scale of World Health Organization Quality of Life (WHOQOL-BREF) was performed before surgery and at 1.5, 3, 6, and 12 months after surgery. RESULTS: The mean visual analog scale pain score, HADS-depression score, and HADS-anxiety score showed a significant decrease from 6.6, 13.3, and 13.9 before surgery to 1.5, 3.9, and 3.7 after 12 months after surgery, respectively (all P < .001). The mean ASES score, WHOQOL-BREF score, and subjective shoulder value showed a significant improvement from 28.5, 32.3, and 23.6% to 81.3, 79.1, and 78.4%, respectively (all P < .001). All outcome measurements showed a significant improvement from 6 weeks after RSA. In multivariate analysis, age was an independent predictor of the final ASES score and WHOQOL-BREF score (P = .037 and .004, respectively). CONCLUSION: This study showed a sequential improvement of emotional status and quality of life as well as functional recovery with pain relief from 6 weeks after RSA in patients with rotator cuff insufficiency. Especially, younger patients had better postoperative functional ability and quality of life. These findings suggest that RSA for rotator cuff insufficiency provides a rapid improvement of emotional status and quality of life.

Complications Related to Latarjet Shoulder Stabilization: A Systematic Review.

BACKGROUND: In cases of recurrent anterior shoulder instability with a glenoid defect, Latarjet procedures are widely used for stabilization. Although complications with this procedure have been reported, few studies have comprehensively analyzed issues related to the Latarjet procedure. PURPOSE: To identify the overall complication rate of the Latarjet procedure used for anterior shoulder instability and to compare the rate of complications between arthroscopic and open approaches. STUDY DESIGN: Systematic review; Level of evidence, 4. METHODS: PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed by using the PubMed, EMBASE, Scopus, and Cochrane Library databases. Data on complications were extracted and classified as intraoperative, postoperative, or instability-related for further analysis. Quality assessments were performed with criteria from the Methodological Index for Nonrandomized Studies (MINORS). A quantitative synthesis of data was conducted to compare the complication rates between arthroscopic and open approaches. RESULTS: A total of 35 articles were included in this analysis. The MINORS score was 11.89. A total 2560 Latarjet procedures (2532 patients) were included. The overall complication rate was 16.1% (n = 412). The intraoperative complication rate was 3.4% (n = 87) and included a 1.9% (n = 48) incidence of nerve injuries and a 1.0% (n = 25) incidence of iatrogenic fractures. Screw problems, vascular injuries, and conversion arthroscopic to open surgery each occurred at a rate of <1%. The postoperative complication rate was 6.5% (n = 166), and the most common complication was nonunion (1.3%; n = 33). The instability-related complication rate was 6.2% (n = 159) and included a 1.5% (n = 38) rate of redislocation, a 2.9% (n = 75) rate of positive apprehension test, and a 1.0% (n = 26) rate of instability. Overall, 2.6% (n = 66) of patients required an unplanned secondary operation after the initial surgery. The arthroscopic approach was associated with a higher rate of intraoperative complications compared with the open approach (5.0% vs 2.9%; P =.020) and a lower rate of instability-related complications (3.1% vs 7.2%; P < .001). CONCLUSION: The Latarjet procedure for anterior shoulder instability results in an overall complication rate of 16.1% and a reoperation rate of 2.6%. However, serious complications at short-term follow-up appear rare. When the arthroscopic approach was used, the rate of intraoperative complications was higher, although instability-related complications were lower when compared with the open approach.