Wei Lun Lui
Introduction
Recurrent anterior shoulder instability is a common clinical problem, and the
optimal surgical intervention remains debated. Arthroscopic Bankart repair and
the Latarjet procedure are widely performed, yet comparative outcome data
continue to evolve. This systematic review and meta-analysis aimed to compare
clinical outcomes between these two procedures.
Methods
A systematic literature search of MEDLINE, CINAHL, and Scopus databases was
conducted up to June 2022 in accordance with PRISMA guidelines. Eligible
studies compared arthroscopic Bankart repair with the Latarjet procedure for
anterior shoulder instability and reported at least one relevant clinical outcome.
Pooled analyses were performed using risk ratios (RRs) for categorical outcomes
and mean differences (MDs) for continuous variables, with 95% confidence
intervals (CIs).
Results
Five cohort studies comprising 3,145 patients were included. Arthroscopic
Bankart repair was associated with significantly higher rates of recurrence (RR
3.09, 95% CI 1.96–4.87) and redislocation (RR 3.74, 95% CI 1.94–7.22) compared with
the Latarjet procedure. Functional outcomes, assessed using the Rowe score,
favored the Latarjet group (MD 7.94, 95% CI −13.00 to −2.87). Conversely, Bankart
repair demonstrated a significantly lower postoperative infection rate (RR 0.14,
95% CI 0.05–0.42). No significant differences were observed between the two
procedures regarding revision surgery or hematoma formation
Conclusion
The Latarjet procedure provides superior shoulder stability and functional
outcomes compared with arthroscopic Bankart repair, albeit with a higher
infection risk. Surgical decision-making should be individualized, taking into
account patient-specific factors, bone loss, and surgeon expertise.
Author
Wei Lun Lui, James Cook University Hospital, Middlesbrough, United Kingdom
Hemant Sharma, Darlington Memorial Hospital, Darlington, United Kingdom