When an Isolated Bankart Repair is Not Enough: Comparing Latarjet Versus Augmentation with Remplissage

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Shoulder Instability Research

Background:

• Recurrence after isolated arthroscopic Bankart repair is high in young athletes.
• Arthroscopic Bankart repair with Remplissage and Latarjet procedure are common surgical strategies.
• Optimal indications for these procedures remain debated.

Purpose of the Study:

• Synthesize evidence on indications, outcomes, and complications of arthroscopic Bankart repair with Remplissage and Latarjet.
• Compare recurrence risk and return to sport rates for both procedures.
• Analyze clinical scenarios and patient profiles for optimal procedure selection.

Main Methods:

• Systematic review of contemporary evidence.
• Analysis of clinical outcomes, recurrence rates, and complication profiles.
• Evaluation of patient-specific factors like bone loss and activity level.

Main Results:

• Both procedures show >80% return to sport rates.
• Recurrence rates: 5-10% for Remplissage, 0-5% for Latarjet.
• Complication rates: ~1.6% for Remplissage, 5.1-16.1% for Latarjet.
• Remplissage is preferred for subcritical bone loss; Latarjet is superior for critical bone loss (>15% glenoid bone loss).

Conclusions:

• Arthroscopic Bankart repair with Remplissage offers durable stabilization for subcritical bone loss, comparable to Latarjet.
• Latarjet procedure provides superior stability and reduces recurrence risk in cases of critical glenoid bone loss or bipolar off-track lesions.
• Careful analysis of glenoid and humeral bone loss is crucial for selecting the optimal surgical strategy for recurrent shoulder instability.