Latarjet Offers Lower 2‐Year Reoperation Rate With Similar Rates of Nerve Injury Compared With Anterior Free Bone Block Procedure in a Large Insurance Claims Database

Purpose To compare the rates of reoperation and nerve injury between patients undergoing the Latarjet procedure and anterior free bone block procedures while also determining national utilization trends among these glenoid bone augmentation procedures. Methods A retrospective study was conducted using the PearlDiver database. Patients undergoing the Latarjet procedure (CPT‐23462) and capsulorrhaphy with anterior free bone block (CPT‐23460) procedures from 2015 to 2022 were identified. Patients were tracked for 2 years after the index surgery to assess the rates of closed reduction, manipulation under anesthesia, open reduction, revision open and arthroscopic stabilization, other arthroscopic procedures, irrigation and debridement, and shoulder arthroplasty using Current Procedural Terminology codes and nerve injury using subsequent International Classification of Diseases‐10 codes. Risk factors for reoperation were identified using univariate and multiple logistic regression. The incidence of each procedure from 2010 to 2022 was queried. Results Patients undergoing anterior free bone block procedures (n = 455) were older (35.5 vs 30.4 years, P < .0001) and had a slightly higher Elixhauser Comorbidity Index (3.3 vs 2.5, P < .0001) than those undergoing Latarjet procedures (n = 2524). The 2‐year reoperation rate after anterior free bone block procedures was higher (13.4%) compared with Latarjet procedures (8.7%, P = .003). There was no significant difference in the rates of revision stabilization between the anterior free bone block cohort (4.8%) and the Latarjet cohort (3.4%, P = .13). The rates of nerve injury after Latarjet (1.3%) and anterior free bone block procedures (2.0%, P = .27) were not significantly different. From 2010 to 2022, Latarjet procedures increased, ( r 2 = 0.5, P = .004), whereas there was no change in the incidence of anterior free bone block procedures ( r 2 = −0.05, P = .53). Conclusions Patients undergoing anterior free bone block procedures had a higher reoperation rate at 2 years with no difference in incidence of nerve injury compared with those undergoing Latarjet procedures, although they were at baseline slightly older and more medically complex. Level of Evidence Level III, retrospective comparative study.