Latarjet procedure for failed Bankart repair provides better stability and return to sports, but worse postoperative pain and external rotation limitations with more complications, compared to revision Bankart repair: a systematic review and meta-analysis

Abstract

PurposeThis study aimed to compare the clinical results of revision Bankart repair versus the Latarjet procedure for failed Bankart repair. MethodsA literature search was performed in databases, such as Pubmed, Embase, and Scopus Library. The studies were appraised using the Methodological Index for Non‐randomized Studies tool. Studies for failed Bankart repair with revision Bankart repair or Latarjet procedure were included. The pain VAS, ROWE score, rate of return to sports and preinjury level of sports, recurrent instability, range of motion, and complications were compared. Additionally, the pain VAS, ROWE score, forward flexion, and external rotation at side were subjected to a meta‐analysis. ResultsTwenty‐four articles were included in the systematic review. The functional outcomes in terms of the ROWE score, recurrent instability, return to sports, and the preinjury level of sports was better in the Latarjet procedure group than those in the revision Bankart repair group (ROWE score, 91 vs. 86.7; recurrent instability rate, 3.5% vs. 14.4%; return to sports rate, 100% vs. 87.9%; return to preinjury level of sports rate, 89.9% vs. 74.9%; all P < 0.001). However, the results of postoperative pain and the postoperative limitation of external rotation at side were worse in the Latarjet procedure group than those in the revision Bankart repair group (pain VAS, 1.4 vs. 0.8; postoperative external rotation at side, 38° vs. 60°; all P < 0.001). In addition, the majority of the complications occurred in the Latarjet procedure group. In the meta‐analysis, the postoperative ROWE score was significantly higher in the Latarjet procedure group than that in the revision Bankart group (revision Bankart repair: 95% CI 88.9–80.9, I2 = 65.70; Latarjet procedure: 95% CI 95.8–88.1, I2 = 93.37; P = 0.014). However, the pain VAS, forward flexion, and external rotation at side did not reach the significant level in the meta‐analysis. ConclusionCompared with revision Bankart repair, the Latarjet procedure for failed Bankart repair showed better ROWE scores, stability, and return to sports or preinjury level of sports; however, the postoperative pain and the limitation of external rotation at side were worse with more complications. IRB NoKUMC 2022–01‐024. Level of evidenceLevel IV.

Is Revision Arthroscopic Bankart Repair a Viable Option? A Systematic Review of Recurrent Instability Following Bankart Repair

“…Our review found that both Bankart and Latarjet techniques significantly enhanced patient outcomes preand post-operatively. Our analysis aligns with Lho et al's findings that Latarjet have shown promising results compared to Bankart in terms of reduced instability and improved Rowe scores [6]. Our systematic review found the Latarjet is a superior for recurrent instability following a Bankart repair.…”

“…Bone block procedures have traditionally been reserved for more severe instability with significant bone loss. The Latarjet procedure is indicated for recurrent instability, failed prior surgery, contact athlete, critical glenoid bone loss, and bipolar bone loss resulting in an off-track lesion [6]. Finally, free flap glenoid bone grafting such as the Eden-Hybinette procedure is indicated for critical bone loss and failed prior Latarjet procedure [7].…”

The arthroscopic treatment of anterior shoulder instability with glenoid bone loss shows similar clinical results after Latarjet procedure and iliac crest autograft transfer

“…Recurrent anterior instability of the glenohumeral joint that is accompanied by glenoid bone loss remains a challenge for shoulder surgeons [20,24]. Improperly addressed glenoid deiciency has been identiied as a main risk factor for failure of soft tissue stabilization methods of the shoulder [35].…”

Arthroscopic Latarjet yields better union and prevention of instability compared to arthroscopic bony Bankart repair in shoulders with recurrent anterior instability: a systematic review

“…Anterior shoulder instability often requires surgical treatment, particularly in young athletes who wish to resume sports [3, 46, 50]. The most common surgical treatments involve either labral or capsular repair in shoulders with no glenoid defects [34, 51], or bone‐block procedures in shoulders with glenoid defects [13, 26, 35]. The Latarjet technique is among the most popular bone‐block procedures, as it proved effective at preventing recurrent dislocations [1, 2, 12, 21, 25, 27, 39] whether performed as an open or an arthroscopic procedure [15, 33].…”