Comparison of clinical and patient-reported outcomes of three procedures for recurrent anterior shoulder instability: arthroscopic Bankart repair, capsular shift, and open Latarjet

Abstract

Background Best surgical of recurrent anterior shoulder instability remained controversial. We knew little about the superiority and choice between traditional open and modern arthroscopic techniques. We hypothesized that outcomes of all patients will be similar regardless of surgical technique. Methods A retrospective case-cohort analysis of 168 patients who had recurrent anterior shoulder instability was conducted from September 2010 to December 2013. All cases (mean age 30.8 [range 18–50] years) were performed with arthroscopic Bankart repair (33 males/20 females), open Latarjet (34 males/18 females), and capsular shift (31 males/14 females). The average follow-up was 67.6 months (range 60–72). The shoulder instability index score (ISIS) was more than 3 with an average of 6.4. Results All treatments proved to be effective in improving shoulder functional status and reducing symptoms, while Latarjet had an advantage over subjective perception. The Rowe scores in arthroscopic Bankart, open Latarjet, and capsular shift group were 92.3 ± 1.5, 96.2 ± 2.1, and 93.2 ± 2.3, respectively, with significant difference. There was no significant difference in other functional outcomes. However, the Latarjet group in subjective results (subjective shoulder value (SSV) and subjective shoulder value for sport practice (SSV Sport)) was superior to the others (P < 0.05). There were two relapsed cases in arthroscopic Bankart and capsular shift group, respectively, and no recurrence in open Latarjet group. Conclusion Arthroscopic Bankart repair has the advantage of mini-invasion and rapid recovery. Capsular shift offers stabilizing of inferior or multidirectional type, especially for little bone defect. Latarjet was more effective in reducing recurrence with higher stability. Level of evidence Therapeutic level III

Arthroscopic Bankart Repair vs. Open Latarjet Procedure: A Comparative Study of Clinical and Functional Results.

“…Our result showed that the open Latarjet procedure to produce better patient-reported outcomes compared to the arthroscopic Bankart procedure, and the external rotation was also not reduced in the Latarjet group. Our results add to the literature that the Latarjet procedure is a viable option with satisfactory clinical and functional outcomes [12,33,18,17,6].…”

“…Patient-reported outcomes, following surgical stabilization procedure, are solely dependent upon the postoperative function, pain, and recurrence [6,17,18]. These factors also determine the functional satisfaction.…”

“…These results resemble the facts of previous ndings that most of the patients are satis ed with the surgery; however, some are not. [6,17,18,33]. Another reason for choosing an arthroscopic procedure is the surgeon's discretion.…”

“…General indication of Latarjet procedure is recurrent shoulder dislocation with a signi cant glenoid bone loss. Both of these surgical techniques have their merits and demerits, which will be debated for years to come; however, surgical satisfaction depends on the clinical outcomes and the recurrence [5,6,[12][13][14][17][18][19][20].…”

Safety and Effectiveness of Intra-articular Corticosteroid Injection Following Arthroscopic Shoulder Surgery

“…Although conservative treatment and open surgery have been the main treatment methods for these diseases, with the popularization of arthroscopy technology, it has become one of the main treatment option [5,6]. The main application advantages of shoulder arthroscopy are less injury of shoulder joint, su cient removal of focus, low postoperative pain and fast recovery [7]. It is estimated that more than 270,000 patients underwent rotator cuff repair in 2006 in the United States and more than 250,000 patients completed rotator cuff repair under shoulder arthroscopy [8].…”