A Comparison of Arthroscopic Bankart Repair and the Latarjet Procedure in Contact Athletes With Anterior Shoulder Instability: A Systematic Review and Meta-analysis

Abstract

Background:

Anterior shoulder instability is a frequent and often career-limiting problem in contact sports. Surgical intervention is frequently required to restore stability and reduce the risk of recurrence. Arthroscopic Bankart repair (ABR) and the Latarjet procedure are widely used, but direct comparative data in contact athletes remain limited.

Purpose:

To compare clinical outcomes, recurrence, complications, and return-to-sport (RTS) timelines between ABR and the Latarjet procedure in contact athletes.

Study Design:

Systematic review and meta-analysis; Level of evidence, 4.

Methods:

A systematic review and meta-analysis was conducted in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The PubMed, Ovid MEDLINE, Embase and Cochrane databases were searched for studies reporting recurrence, revision, complications, RTS, and functional outcomes in contact athletes undergoing primary ABR or the Latarjet procedure for anterior shoulder instability.

Results:

In total, 29 studies involving 2103 patients (1443 ABR, 660 Latarjet) were included in this analysis. The Latarjet procedure demonstrated a lower recurrence rate (7% vs 15%; P = .014) but similar revision rates (6% for the Latarjet procedure vs 7% for ABR; P = .402). ABR was associated with fewer complications (2% vs 8%; P < .0001). Both procedures achieved high RTS rates (89% for ABR vs 86% for the Latarjet approach) and similar rates of return to the same level of play (78% vs 76%), with no differences under random-effects models. The mean time to RTS was comparable (5.34 months for ABR vs 5.88 months for the Latarjet procedure; P = .365). Pooled postoperative Rowe scores (89.48 for Bankart; 87.41 for the Latarjet procedure; P = .27) and Athletic Shoulder Outcome Scoring System scores were also similar, indicating good functional recovery across both groups.

Conclusion:

This meta-analysis shows that the Latarjet procedure provides lower recurrence, although at the cost of higher complication risk. ABR offers a safer perioperative profile but with greater risk of recurrent instability. Despite these differences, both procedures achieve comparable revision rates, functional outcomes, RTS rates, and time to return. Procedure selection should therefore be individualized, balancing the athlete's risk of recurrence, tolerance of complications, and performance goals.