Arthroscopic Bankart Repair Versus Open Latarjet Repair for Anterior Shoulder Instability: A Systematic Review and Meta-Analysis.

Abstract

Background: Anterior shoulder instability is prevalent among young, active individuals, especially athletes. The optimal surgical intervention remains debated between Arthroscopic Bankart repair and Open Latarjet procedure.

Objectives: The Open Latarjet procedure results in lower recurrence rates and better functional outcomes compared with the Arthroscopic Bankart repair in patients with recurrent anterior shoulder instability, particularly those with significant glenoid bone loss and multiple preoperative dislocations.

Design: A systematic review and meta-analysis were conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Methods: Databases searched included PubMed, Google Scholar, and the Cochrane Library. Inclusion criteria encompassed studies comparing Arthroscopic Bankart repair with Open Latarjet procedure, reporting on recurrence rates, functional outcomes, and complications. Data extraction and risk of bias assessment were performed independently by 3 reviewers.

Results: 15 studies with 1636 patients were included. The Open Latarjet group exhibited significantly lower recurrence rates (4.2%) compared with the Arthroscopic Bankart group (11.8%). Functional scores (Rowe, WOSI, and ASES) were higher in the Latarjet group. Complication rates were similar, but the Bankart group had higher rates of redislocation and revision surgeries. Subgroup analyses revealed that patients with significant glenoid bone loss and multiple preoperative dislocations benefited more from the Latarjet procedure.

Conclusion: The Open Latarjet procedure offers superior outcomes for patients with recurrent anterior shoulder instability, especially those with significant bone loss and multiple dislocations. Surgical decision-making should be individualized, considering patient-specific factors.