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Epidemiology of Shoulder Instability Procedures: An Analysis of Complications and Costs

Epidemiology of Shoulder Instability Procedures: An Analysis of Complications and Costs

Amil Agarwal, BS, UNITED STATES Jacob D Mikula, MD, UNITED STATES Suresh K Nayar, MD, UNITED STATES Sribava Sharma, MS, UNITED STATES Matthew J Best, MD, UNITED STATES Edward G McFarland, MD, FAAOS, UNITED STATES Uma Srikumaran, MD, MBA, MPH, UNITED STATES

Johns Hopkins University, Baltimore, MD, UNITED STATES


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Summary: Anterior bone block reconstruction and Latarjet procedures were associated with the highest rates of 90-day medical and surgery-specific complications, while arthroscopic Bankart repair was associated with the highest costs.


Background

Recurrent shoulder instability is a debilitating condition that can lead to chronic pain, decreased function, and inability to return to activities or sport. This retrospective epidemiology study was performed to report 90-day postoperative complications and costs of Latarjet, anterior bone block reconstruction, arthroscopic and open Bankart repair for shoulder instability.

Methods

Patients 18 years and older who underwent four primary shoulder surgeries from 2010-2019 were identified using national claims data. Patient demographics, comorbidities, and 90-day postoperative complications were analyzed using univariate analysis and multivariable logistic regression. Total and itemized 90-day reimbursements were determined for each procedure.

Results

The 90-day medical and surgery-specific complication rates were highest for anterior bone block reconstruction, followed by Latarjet. Arthroscopic Bankart repair had the highest 90-day costs and primary procedure costs compared to other procedures.

Conclusion

Anterior bone block reconstruction and Latarjet procedures were associated with the highest rates of 90-day medical and surgery-specific complications, while arthroscopic Bankart repair was associated with the highest costs.


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