Bankart Repair Versus Latarjet Procedure for Recurrent Anterior Shoulder Instability: A Systematic Review and Meta-analysis of 3275 Shoulders

Abstract

Background:

Little consensus is available regarding the standard treatment for recurrent anterior instability of the shoulder. Typically, treatment selection has been based on training and tradition rather than the available evidence.

Purpose:

This study aimed to compare the clinical outcomes between arthroscopic Bankart procedure and the Latarjet procedure in the treatment of recurrent anterior shoulder instability with emphasis on follow-up time.

Study Design:

Systematic review and meta-analysis.

Methods:

We searched PubMed, Cochrane Central Register of Controlled Trials, Scopus, Ovid, and Web of Science up to January 2018 and included studies that compared arthroscopic Bankart versus Latarjet for treatment of anterior shoulder instability. Continuous data, such as operative time and patient-reported outcomes, were pooled as mean differences (MDs), whereas dichotomous data, such as recurrence, revision, redislocation, arthropathy, infection, and hematoma, were pooled as risk ratios (RRs), with 95% CIs.

Results:

Pooling data from 7 cohort studies (3275 patients) showed that arthroscopic Bankart was associated with a higher risk of redislocation (RR, 2.74; 95% CI, 1.48-5.06; P = .03), a higher risk of recurrence (RR, 2.87; 95% CI, 1.91-4.30; P < .0001), and a lower risk of infection (RR, 0.16; 95% CI, 0.06-0.43; P = .0002) compared with Latarjet, while the effect size did not favor arthroscopic Bankart or Latarjet in terms of Rowe score (MD, 0.22; 95% CI, –5.64 to 6.08; P = .94), revision (RR, 0.34; 95% CI, 0.08-1.39; P = .13), and hematoma (RR, 0.20; 95% CI, 0.03-1.19; P = .07). The effect estimate showed a pronounced advantage for Latarjet from 6 to 10 years postoperatively in terms of recurrence and redislocation (RR, 3.00; 95% CI, 1.98-4.56 and RR, 2.85; 95% CI, 1.51-5.38, respectively).

Conclusion:

Our results showed that Latarjet had less risk of recurrence and redislocation with longer follow-up time. Both procedures were comparable in terms of Rowe score, the need for revision, and postoperative hematoma formation, whereas Bankart repair was associated with a lower risk of infection.

Keywords

shoulder instability Bankart repair Latarjet recurrent instability

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References

Altman

Bland

. Standard deviations and standard errors. BMJ. 2005;331(7521):903.

Sivakumar

Phan

Trantalis

. A systematic review and meta-analysis of clinical and patient-reported outcomes following two procedures for recurrent traumatic anterior instability of the shoulder: Latarjet procedure vs. Bankart repair. J Shoulder Elbow Surg. 2016;25(5):853-863.

Bessiere

Trojani

Carles

Mehta

Boileau

. The open Latarjet procedure is more reliable in terms of shoulder stability than arthroscopic Bankart repair. Clin Orthop Relat Res. 2014;472(8):2345-2351.

Bessiere

Trojani

Pelegri

Carles

Boileau

. Coracoid bone block versus arthroscopic Bankart repair: a comparative paired study with 5-year follow-up. Orthop Traumatol Surg Res. 2013;99(2):123-130.

Blonna

Bellato

Caranzano

Assom

Rossi

Castoldi

. Arthroscopic Bankart repair versus open Bristow-Latarjet for shoulder instability: a matched-pair multicenter study focused on return to sport. Am J Sports Med. 2016;44(12):3198-3205.

Bokshan

DeFroda

Owens

. Comparison of 30-day morbidity and mortality after arthroscopic Bankart, open Bankart, and Latarjet-Bristow procedures: a review of 2864 cases. Orthop J Sports Med. 2017;5(7):2325967117713163.

Cho

Yoo

Rhee

. Management of an engaging Hill-Sachs lesion: arthroscopic remplissage with Bankart repair versus Latarjet procedure. Knee Surg Sports Traumatol Arthrosc. 2016;24(12):3793-3800.

Gilat

Haunschild

Lavoie-Gagne

Tauro

Knapik

Cole

. Outcomes of the Latarjet Procedure Versus Free Bone Block Procedures for Anterior Shoulder Instability: A Systematic Review and Meta-analysis. Am J Sports Med. doi:10.1177/03635 46520925833

Higgins

Green

. Cochrane handbook for systematic reviews of interventions. London: The Cochrane Collaboration; 2008.

10.

Hovelius

Augustini

Fredin

Johansson

Norlin

Thorling

. Primary anterior dislocation of the shoulder in young patients: a ten-year prospective study. J Bone Joint Surg Am. 1996;78(11):1677-1684.

11.

Hovelius

Saeboe

. Neer Award 2008: Arthropathy after primary anterior shoulder dislocation—223 shoulders prospectively followed up for twenty-five years. J Shoulder Elbow Surg. 2009;18(3):339-347.

12.

Hozo

Djulbegovic

Hozo

. Estimating the mean and variance from the median, range, and the size of a sample. BMC Med Res Methodol. 2005;5:13.

13.

Jensen

Bongaerts

Bruhn

Schneider

. Not all Rowe scores are the same! Which Rowe score do you use? J Shoulder Elbow Surg. 2009;18(4):511-514.

14.

Latarjet

. Treatment of recurrent dislocation of the shoulder. Lyon Chir. 1954;49(8):994-997.

15.

Moher

Shamseer

Clarke

, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev. 2015;4:1.

16.

Olds

Ellis

Donaldson

Parmar

Kersten

. Risk factors which predispose first-time traumatic anterior shoulder dislocations to recurrent instability in adults: a systematic review and meta-analysis. Br J Sports Med. 2015;49(14):913-922.

17.

Patte

Debeyre

. Recurrent dislocation of the shoulder. Encycl Med Chir Paris Technique Chirurgical Orthopedie. 1980;44265:4-4.

18.

Robinson

Howes

Murdoch

Will

Graham

. Functional outcome and risk of recurrent instability after primary traumatic anterior shoulder dislocation in young patients. J Bone Joint Surg Am. 2006;88(11):2326-2336.

19.

Rowe

Patel

Southmayd

. The Bankart procedure: a long-term end-result study. J Bone Joint Surg Am. 1978;60(1):1-16.

20.

Stang

. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol. 2010;25(9):603-605.

21.

Stroup

Berlin

Morton

, et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis of Observational Studies in Epidemiology (MOOSE) group. JAMA. 2000;283(15):2008-2012.

22.

Thomazeau

Courage

Barth

, et al. Can we improve the indication for Bankart arthroscopic repair? A preliminary clinical study using the ISIS score. Orthop Traumatol Surg Res. 2010;96(8)(suppl):S77-S83.

23.

Williams

HLM

Evans

Furness

Smith

. It’s not all about redislocation: a systematic review of complications after anterior shoulder stabilization surgery. Am J Sports Med. 2019;47(13):3277-3283.

24.

Zimmermann

Scheyerer

Farshad

Catanzaro

Rahm

Gerber

. Long-term restoration of anterior shoulder stability: a retrospective analysis of arthroscopic Bankart repair versus open Latarjet procedure. J Bone Joint Surg Am. 2016;98(23):1954-1961.