Long-Term, Latarjet Beats Bankart for Anterior Shoulder Instability

In a retrospective case-cohort analysis of 364 shoulders that had primary repair of recurrent anterior instability, Zimmermann et al. conclude in the December 7, 2016 issue of JBJS that arthroscopic Bankart repairs were inferior to the open Latarjet procedure, at a mean follow-up of 10 years.

Specific 10-year outcome comparisons included:

• Redislocations in 13% of the Bankart shoulders vs 1% of the Latarjet shoulders
• Apprehension (fear of the shoulder dislocating with the arm in abduction and external rotation) in 29% of the Bankart patients vs 9% of the Latarjet patients
• Cumulative revision rate for recurrent instability of 21% in the Bankart group vs 1% in the Latarjet group
• Not-satisfied rating from 13.2% of patients in the Bankart group vs 3.2% in the Latarjet group

Overall, there were few early and almost no late failures after the Latarjet procedure, while the arthroscopic Bankart repair was associated with an increasing failure rate over time. The authors say that this study’s longer-term analysis confirms “the contention that arthroscopic Bankart reconstructions fail progressively” and supports “the observation that restoration of stability with the Latarjet procedure is stable over time.”