Female Patients Undergoing Latarjet Surgery Demonstrate Similar Two-Year Secondary Surgery Rates but Greater Risk of Emergency Department Visits Compared to a Matched Cohort of Male Patients

Purpose To evaluate sex-based differences in 30-day postoperative emergency department (ED) visits, 90-day complications, and two-year secondary surgery rates following the Latarjet procedure for the treatment of recurrent shoulder instability. Methods A national administrative claims database was used to identify patients with International Classification of Diseases (ICD)-10 diagnosis codes for shoulder subluxation or dislocation on the day of first-time stabilization with the Latarjet technique between 2015 and 2021. Male patients were matched 4:1 to female patients based on age, Elixhauser Comorbidity Index (ECI) score, and body mass index (BMI) class. Rates of 30-day ED visits and 90-day complications were compared between cohorts, and risk factors for ED visits were identified by multivariate regression. Incidence of secondary surgery within two years was compared by Kaplan-Meier analysis. Results Prior to matching, 1059 males and 360 females met inclusion/exclusion criteria. Subsequent 4:1 (male-to-female) matching controlling for age, ECI, and BMI yielded 694 males and 185 females who underwent the Latarjet procedure. The overall incidence of 30-day ED visits was 9.3%, including 8.2% for males and 13.5% for females. Based on multivariate logistic regression, these 30-day ED visits were associated with female sex (OR, 1.79; P=0.029) and incrementally higher ECI scores; relative to ECI 0, ECI scores of 1-2, 3-4, and >5 were associated with ORs of 5.31 (P=0.006), 8.12 (P<0.001), and 12.84 (P<0.001), respectively. Ninety-day complications occurred in 1.5% of the total cohort, and incidence was not statistically different between sexes. Overall two-year secondary surgery rate was similar between male and female patients (5.1% vs. 6.7%, respectively; P=0.4). Conclusion Female patients undergoing the Latarjet procedure for recurrent shoulder instability demonstrated similar 90-day complication and two-year secondary surgery rates compared to a matched cohort of male patients. Female sex, along with ECI score, however, were associated with a greater rate of 30-day ED visits.