Abstract
Objectives:
This retrospective comparative study aimed to compare the short to mid-term outcomes, including recurrence, complications, and patient-reported outcome measures (PROMs) of arthroscopic Bankart and open Latarjet procedures in patients with recurrent anterior shoulder instability.
Methods:
All patients with recurrent shoulder instability who underwent either arthroscopic Bankart or open Latarjet procedures between 2008 and 2020 with at least 1-year of follow-up were included in the study. Their surgery results and patient-reported outcome measures were assessed using the Oxford Shoulder Score (OSS) and Shoulder Pain and Disability Index (SPADI).
Results:
One-hundred thirty-three patients were analyzed in 2 groups: Latarjet (n = 67) and Bankart (n = 66). Before surgery, the 2 groups of patients were similar regarding surgery side, education level, occupation difficulty level, and smoking (P > 0.05). However, Latarjet patients were younger (32 ± 9 vs. 35 ± 9, P=0.04), had a higher proportion of male patients (95.5% vs. 81.8%, P=0.01), and had a significantly shorter follow-up period (3.2 ± 2.6 vs. 6.4 ± 3.0 years, P<0.001) than the Bankart group.
There was no significant difference between the Latarjet and Bankart groups regarding the follow-up OSS score (37 ± 6 vs. 36 ± 9; P=0.94) and SPADI score (22 ± 14 and 24 ± 20, P=0.80). There was only 1 case (1.5%) of dislocation in the Latarjet group, but none in the Bankart group (P=1.0). Subluxation was observed in 5 patients (7.5%) of the Latarjet group and in 3 patients (4.5%) of the Bankart group (P=0.4).
In the Bankart group, male patients had significantly superior OSS and SPADI scores compared with female patients, and follow-up time was significantly correlated with better OSS score (r=0.28) and better SPADI score (r=-0.28) (P<0.05). Latarjet group results showed that younger age was significantly associated with better OSS (r=-0.26) and better SPADI scores (r=0.25 (P<0.05).
Conclusions:
Our findings confirm that both Bankart and Latarjet are reliable techniques in short- to mid-term follow-up based on the bone loss cut off of 15%. Patients can be consulted regarding early arthroscopic intervention soon after the shoulder dislocation becomes recurrent in contrast to waiting too long to require a more extensive Latarjet procedure, albeit with comparable outcomes.
