Arthroscopic Bankart versus Open Latarjet; Short-to-Mid-Term Outcomes of Recurrence and Patient-Reported Outcomes in Patients with Recurrent Anterior Shoulder Dislocation

Abstract

Objectives This retrospective comparative study compared the short to mid-term outcomes of arthroscopic Bankart repair and open Latarjet procedures in patients with recurrent anterior shoulder instability. Methods Patients who underwent either arthroscopic Bankart repair or open Latarjet procedures between 2008 and 2020, with at least one year of follow-up, were included. Arthroscopic Bankart repairs were performed on shoulders with minimal glenoid bone loss (<15%), and the Latarjet procedure was performed if the preoperative computed tomography (CT) scan showed a 15% bone loss on the glenoid side or 30-40% humeral head bone loss. Their surgery results and patient-reported outcome measures (PROMs) were assessed using the Oxford Shoulder Score (OSS) and Shoulder Pain and Disability Index (SPADI). Results 133 patients were analyzed in Latarjet (n = 67) and Bankart groups (n = 66). Before surgery, the two groups of patients were similar regarding surgery side, hand dominance, education level, occupation difficulty level, and smoking (P>0.05). However, Latarjet’s patients were younger (32 vs. 35, P=0.04), had a higher proportion of males (96% vs. 82%, P=0.01), and had a significantly shorter follow-up period (3.2 vs. 6.4 years, P<0.001) than the Bankart group. There was no significant difference between the Latarjet and Bankart groups regarding the follow-up’s OSS score (37 vs. 36; P=0.94) and SPADI score (22 vs. 24, P=0.80). Dislocation was observed in only one patient (1.5%) in the Latarjet group (P=1.0). Subluxation was observed in 5 patients (7.5%) of the Latarjet group and three patients (4.5%) of the Bankart group (P=0.4). The overall instability rate was similar (P>0.05). Conclusion Our findings suggest that both arthroscopic Bankart repair and open Latarjet are reliable techniques in short to mid-term follow-up based on the glenoid bone loss cut-off of 15%. Level of Evidence Therapeutic Level III