Bankart versus Latarjet operation as a revision procedure after a failed arthroscopic Bankart repair

Elamo, Sami; Selänne, Liisa; Lehtimäki, Kaisa; Kukkonen, Juha; Hurme, Saija; Kauko, Tommi; Äärimaa, Ville

doi:10.1016/j.jseint.2020.01.004

Cited by 23 publications

(29 citation statements)

References 23 publications

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“…That study revealed a higher recurrence rate in the group that underwent revision arthroscopic Bankart repair (43% vs 0% for Latarjet procedure) and poorer patient-reported outcomes. Those findings appear to contradict our findings, although Elamo et al 13 did not analyze glenoid bone defects and a well-designed prospective randomized controlled study is needed to address this issue.…”

Section: Discussioncontrasting

confidence: 99%

Clinical Outcomes of Revision Arthroscopic Capsulolabral Repair for Recurrent Anterior Shoulder Instability With Moderate Glenoid Bone Defects: A Comparison With Primary Surgery

Jeon

Kim²,

Rhee

et al. 2021

Orthopaedic Journal of Sports Medicine

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Background: The optimal revision surgery for failed primary arthroscopic capsulolabral repair (ACR) has yet to be determined. Revision ACR has shown promising results. Purpose: To compare the functional, strength, and radiological outcomes of revision ACR and primary ACR for anterior shoulder instability. Study Design: Cohort study; Level of evidence, 3. Methods: Between March 2007 and April 2017, a total of 85 patients underwent ACR (revision: n = 23; primary: n = 62). Functional outcome scores and positive apprehension signs were evaluated preoperatively, at 1 year, and then annually. Isokinetic internal and external rotation strengths were evaluated preoperatively and at 1 year after surgery. Results: The mean follow-up was 36.5 ± 10.2 months (range, 24-105 months). There was no significant difference between the revision and primary groups in the glenoid bone defect size at the time of surgery (17.3% ± 4.8% vs 15.4% ± 5.1%, respectively; P = .197). At the final follow-up, no significant differences were found in the American Shoulder and Elbow Surgeons score (97.6 ± 3.1 vs 98.0 ± 6.2, respectively; P = .573), Western Ontario Shoulder Instability Index score (636.7 ± 278.1 vs 551.1 ± 305.4, respectively; P = .584), or patients with a positive apprehension sign (17.4% [4/23] vs 11.3% [7/62], respectively; P = .479) between the revision and primary groups. There was no significant difference between the revision and primary groups for returning to sports at the same preoperative level (65.2% vs 80.6%, respectively; P = .136) and anatomic healing failure at 1 year after surgery (13.0% vs 3.2%, respectively; P = .120). Both groups recovered external rotation strength at 1 year after surgery (vs before surgery), although the strength was weaker than in the uninvolved shoulder. In the revision group, a larger glenoid bone defect was significantly related to a positive apprehension sign (22.0% ± 3.8%) vs a negative apprehension sign (16.0% ± 3.2%; cutoff = 20.5%; P = .003). Conclusion: In patients with moderate glenoid bone defect sizes (10%-25%), clinical outcomes after revision ACR were comparable to those after primary ACR. However, significant glenoid bone loss was related to a positive remaining apprehension sign in the revision group. Surgeons should consider these findings when selecting their revision strategy for patients with failed anterior shoulder stabilization.

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Section: Discussioncontrasting

confidence: 99%

Clinical Outcomes of Revision Arthroscopic Capsulolabral Repair for Recurrent Anterior Shoulder Instability With Moderate Glenoid Bone Defects: A Comparison With Primary Surgery

Jeon

Kim²,

Rhee

et al. 2021

Orthopaedic Journal of Sports Medicine

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“…This study reported no direct comparisons between the arthroscopic and Latarjet groups [16]. Another study found significant differences favoring the Latarjet group in recurrent instability (P = .0007), Subjective Shoulder Value (P = .0368), Western Ontario Shoulder Instability index (P = .0166) and osteoarthritis at follow-up (P = .0318) [12]. Only 1 study reported data regarding sporting activity for patients undergoing revision arthroscopic Bankart repair after a failed primary arthroscopic repair [6].…”

Section: Resultsmentioning

confidence: 82%

“…The most frequent complication was recurrent instability (19.9%; N = 56). Recurrent instability was defined as a postoperative dislocation in 4 studies [15,35,40,44], a traumatic event requiring surgical intervention in 2 studies [6,12], and a subluxation or dislocation in 2 studies [3,16]. Other common complications included osteoarthritis (6.8%; N =19), persistent postoperative apprehension (2.5%; N = 7), and traumatic fracture of the glenoid (0.4%; N = 1; Table 2).…”

Section: Resultsmentioning

confidence: 99%

Revision Arthroscopic Bankart Repair for Anterior Shoulder Instability After a Failed Arthroscopic Soft-Tissue Repair Yields Comparable Failure Rates to Primary Bankart Repair: A Systematic Review

Shanmugaraj

Sakha

Tejpal

et al. 2021

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

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Background: The management of recurrent instability after arthroscopic Bankart repair remains challenging. Of the various treatment options, arthroscopic revision repairs are of increasing interest due to improved visualization of pathology and advancements in arthroscopic techniques and instrumentation. Purpose: We sought to assess the indications, techniques, outcomes, and complications for patients undergoing revision arthroscopic Bankart repair after a failed index arthroscopic soft-tissue stabilization for anterior shoulder instability. Methods: We performed a systematic review of studies identified by a search of Medline, Embase, and PubMed. Our search range was from data inception to April 29, 2020. Outcomes include clinical outcomes and rates of complication and revision. The Methodological Index for Non-randomized Studies (MINORS) was used to assess study quality. Data are presented descriptively. Results: Twelve studies were identified, comprising 279 patients (281 shoulders) with a mean age of 26.1 ± 3.8 years and a mean follow-up of 55.7 ± 24.3 months. Patients had improvements in postoperative outcomes (eg, pain and function). The overall complication rate was 29.5%, the most common being recurrent instability (19.9%). Conclusion: With significant improvements postoperatively and comparable recurrent instability rates, there exists a potential role in the use of revision arthroscopic Bankart repair where the glenoid bone loss is less than 20%. Clinicians should consider patient history and imaging findings to determine whether a more rigorous stabilization procedure is warranted. Large prospective cohorts with long-term follow-up and improved documentation are required to determine more accurate failure rates.

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“…57 Outcomes of the Latarjet procedure show high return to sport percentages in long term follow up studies. 62,63 Studies by Yapp et al and Elamo et al, authors found a 100% return to sport rate at 5-year and 10-year follow up respectively with overall excellent patient reported outcomes (PROs). 62,63 Chillemi et al conducted a study with a 25 year follow up in which none of the 40 patients reported any episode of redislocation.…”

Section: Indications and Outcomes Of Open Latarjet Surgerymentioning

confidence: 99%

“…62,63 Studies by Yapp et al and Elamo et al, authors found a 100% return to sport rate at 5-year and 10-year follow up respectively with overall excellent patient reported outcomes (PROs). 62,63 Chillemi et al conducted a study with a 25 year follow up in which none of the 40 patients reported any episode of redislocation. 64 Studies have shown that post-operative complications from open Latarjet procedure range from 7-30%.…”

Section: Indications and Outcomes Of Open Latarjet Surgerymentioning

confidence: 99%

Open Stabilization Procedures of the Shoulder in the Athlete: Indications, Techniques, and Outcomes

Haratian¹,

Yensen²,

Bell³

et al. 2021

OAJSM

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Bankart versus Latarjet operation as a revision procedure after a failed arthroscopic Bankart repair

Cited by 23 publications

References 23 publications

Clinical Outcomes of Revision Arthroscopic Capsulolabral Repair for Recurrent Anterior Shoulder Instability With Moderate Glenoid Bone Defects: A Comparison With Primary Surgery

Clinical Outcomes of Revision Arthroscopic Capsulolabral Repair for Recurrent Anterior Shoulder Instability With Moderate Glenoid Bone Defects: A Comparison With Primary Surgery

Revision Arthroscopic Bankart Repair for Anterior Shoulder Instability After a Failed Arthroscopic Soft-Tissue Repair Yields Comparable Failure Rates to Primary Bankart Repair: A Systematic Review

Open Stabilization Procedures of the Shoulder in the Athlete: Indications, Techniques, and Outcomes

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