AJSM Webinar Series: Management of Anterior Shoulder Instability: A Highlight of the Top 4 Articles in AJSM (2024 to 2025) - Recording-Barth - Long-term Recurrence Rates After Isolated Arthroscopic Bankart Repair

Barth - Long-term Recurrence Rates After Isolated Arthroscopic Bankart Repair

Pdf Summary

This matched-pair cohort study analyzed long-term outcomes of isolated arthroscopic Bankart repair (IAB) versus open Latarjet procedure (OLP) in patients with recurrent anterior shoulder instability but no preoperative bone loss. The investigation involved 774 shoulders operated between 2007 and 2021, with 45 IAB patients matched 1:1 with 45 OLP patients by demographic and clinical variables.<br /><br />At a mean follow-up of 9 years and 3 months, the study found a significantly higher recurrence rate of instability with IAB (20%) compared to OLP (2%) (P = .04), representing an 11-fold increased odds of recurrence for IAB patients. Recurrences after IAB appeared up to 14 years post-surgery, while OLP showed no recurrences after 4 years. Clinical outcomes such as external rotation, pain levels (visual analog scale), functional scores (Walch and Duplay score), and rates of return to previous sport levels were comparable between groups. However, patient satisfaction was higher in the OLP group (98% vs. 82%, P = .02).<br /><br />The study emphasized that even among carefully selected patients with no bone loss and lower Instability Severity Index Scores, IAB failed to maintain long-term shoulder stability within an acceptable recurrence threshold of 5%. The data suggest that reliance solely on the instability score may be insufficient to predict successful outcomes for IAB. Although additional soft-tissue procedures like remplissage can reduce short-term recurrences, long-term follow-up is essential to assess durability.<br /><br />Limitations include its retrospective design, single-surgeon, single-center setting, and patient population mainly involved in contact sports, potentially limiting generalizability. Despite these, this is a comprehensive long-term comparative study with robust propensity score matching.<br /><br />In conclusion, for recurrent anterior shoulder instability without bone loss in young active patients, the open Latarjet procedure offers superior long-term stability with markedly lower recurrence rates than isolated arthroscopic Bankart repair, supporting OLP as the preferred surgical stabilization method in this context.

Keywords

isolated arthroscopic Bankart repair

open Latarjet procedure

recurrent anterior shoulder instability

long-term outcomes

recurrence rate

shoulder stability

Instability Severity Index Score

remplissage

propensity score matching

patient satisfaction