Comparison of Bankart repair with remplissage and Latarjet procedure for anterior shoulder instability: a systematic review and meta-analysis.

BACKGROUND

Anterior shoulder instability is the most common type of shoulder instability. For cases with subcritical glenoid bone loss, both Bankart repair with remplissage (BR) and the Latarjet procedure are viable surgical options. The aim of this study was to compare the postoperative outcomes in patients undergoing BR and Latarjet procedure.

METHODS

This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. The methodological index for nonrandomized studies (MINORS) was used to characterize the methodological quality. A literature search was conducted using PubMed, the Cochrane Library, Embase, Web of Science, and Scopus. The analyzed outcomes included postoperative Rowe score, visual analog scale (VAS) score, the Single Assessment Numeric Evaluation (SANE) score, range of motion (ROM), return-to-sport (RTS) rate, RTS time, recurrence rate, revision rate, and complications. Subgroup analysis was performed on the basis of follow-up duration.

RESULTS

Overall, 12 studies involving 1186 patients were included. The meta-analysis showed that BR was associated with a significantly lower complication rate than the Latarjet procedure. No significant differences were observed in functional outcomes, ROM, recurrence, revision, RTS, or RTS time. Subgroup analysis showed a significant interaction between follow-up duration and outcomes, particularly for VAS and Rowe scores, with a trend toward better short-term results for BR and better longer-term results for Latarjet.

CONCLUSIONS

BR and the Latarjet procedure provide comparable clinical outcomes for anterior shoulder instability, with BR demonstrating a significantly lower complication rate. Follow-up duration may influence VAS and Rowe outcomes, suggesting a potential temporal shift in treatment effects.

LEVEL OF EVIDENCE: Level III.

TRIAL REGISTRATION: CRD42024582343.