Live Surgery: A retrospective study on the outcomes and complications of 7 orthopedic live surgery events

Live surgery increases operative time but not complication rate in patients undergoing arthroscopic anatomic glenoid reconstruction

OBJECTIVES

Live broadcast surgery is an innovative method of remotely introducing new operative techniques to surgeons globally. However, due to the potential impact on patient outcomes, its use remains somewhat controversial. The objective of this study was to determine the effect of live surgery on operative time and perioperative complication rate in patients undergoing arthroscopic anatomic glenoid reconstruction (AAGR) for shoulder instability. We hypothesized that live surgery would maintain a similar surgical time and intraoperative and postoperative complication profile.

METHODS

This was a retrospective review of 94 patients who underwent AAGR between 2013 and 2023. A 1:1 ratio was used to match patients who underwent live virtual AAGR (live broadcast group) to patients who underwent AAGR without live surgery (no broadcast group), based on sex, body mass index, and age. The primary outcome for the study was surgical time, defined as the time from initial incision to final closure. Second, we compared the intraoperative and perioperative complications between the groups.

RESULTS

The live broadcast group had a statistically significantly longer procedure time compared with the no broadcast group (86.90 ​± ​13.1 vs. 80.70 ​± ​14.0 ​min, p ​= ​0.04). Neither group experienced intraoperative complications nor were perioperative complications statistically significantly different between the groups (p ​= ​0.62). One patient (2.4 ​%) in the live broadcast group developed a postoperative hematoma, while one patient (2.4 ​%) in the no broadcast group developed a wound infection.

CONCLUSIONS

This study demonstrated that live surgeries are on average 6 ​min longer than surgeries that are not broadcast live but are not associated with increased complications in patients undergoing AAGR. Surgeons globally could benefit from this teaching platform without increased risk to the patient.

LEVEL OF EVIDENCE

Level III (observational).

Clinical and radiological outcome after arthroscopic rotator cuff repair using PEEK-CF anchors

PURPOSE

The goal of this study was to evaluate the clinical and radiological outcome after arthroscopic rotator cuff repair using new carbonfiber reinforced polyetheretherketone (CF-PEEK) suture anchors.

METHODS

One hundred (n=100) patients with rotator cuff tears were enrolled at seven French hospitals between July 2019 and June 2020. Pain levels, Constant score and Subjective Shoulder Value (SSV) were taken preoperatively and 6months postoperatively. Ultrasonography (US) was performed at 6months postoperatively to evaluate tendon healing using the Sugaya classification. Statistical analysis was done with the Student t-test with 95% confidence intervals.

RESULTS

One hundred patients of the 100 patients were followed at 6months. The mean SSV and Constant score improved from 40.1% preoperatively to 78% at 6months (p<0.0001) and from 43 points preoperatively to 65 points at 6months (p<0.0001), respectively. The mean level of pain, as measured with the visual analogue scale, decreased from 5.9 to 1.6 (p<0.001). There were no postoperative complications that resulted in revision surgery.

CONCLUSION

The study showed good results at 6months follow-up using carbonfiber reinforced PEEK anchors with improved Constant and SSV scores as well as a high ultrasonographic tendon healing rate, making PEEK-CF anchors safe to use, comparable to commonly used anchors.

LEVEL OF EVIDENCE

IV.