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A Comparison of Return to Sport After Bankart Repair Versus Latarjet for Shoulder Instability: A Systematic Review
Claire E Noyes1,2, Grace E Johnston1, Nicholas Vaver1
1Department of Orthopedics, School of Medicine, University of Colorado, Aurora, Colorado, USA.
Background:
Glenohumeral instability can be addressed surgically with repair of the capsulolabral complex, the "Bankart" repair, or bone augmentation with coracoid autograft, the "Latarjet" procedure. Superior return-to-sport (RTS) rates with either Bankart repair or Latarjet have yet to be delineated, and it remains unclear which surgical procedure is optimal.
Purpose:
To review the current literature and report on RTS data for patients who received Bankart repair or Latarjet to address glenohumeral instability.
Study Design:
Systematic review; Level of evidence, 4.
Methods:
This systematic review and meta-analysis was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines by an individual researcher screening through 3 databases (PubMed, Cochrane Library, Embase) for articles including RTS rates after Bankart repair and Latarjet. Eight studies that met inclusion and exclusion criteria were included for review.
Results:
Meta-analysis included 874 athletes who underwent shoulder stabilization: 479 Bankart repair and 395 Latarjet. An overall 94.4% of athletes returned to sport with no statistically significant difference between the surgical groups. Of 665 athletes, 68.1% returned to sport at the same level or higher with no statistically significant difference between the groups. RTS time among the 665 athletes averaged 6 months with no statistically significant difference between the groups. A total of 56 athletes did not RTS: 33 (7.4%) Bankart repair and 23 (6.3%) Latarjet. There was a statistically significant difference (P < .0001) in recurrent instability rates. Bankart repair (14.8%) was 4 times more likely to result in recurrent instability as compared with Latarjet (3.5%). A total of 85 athletes, 71 Bankart repair and 14 Latarjet, had recurrent instability with 53.5% (7.9% overall) and 100% (3.5% overall) requiring a revision procedure, respectively.
Conclusion:
Bankart repair and Latarjet have a high RTS rate with no significant difference in rate, rate of return to previous level of play, or time. One of 4 athletes will not return to the level played before surgery, independent of stabilization technique. Bankart repair is 4 times more likely to result in recurrent instability as compared with Latarjet.