Coracoid bone block versus arthroscopic Bankart repair: A comparative paired study with 5-year follow-up

Bessière, Charles; Trojani, Christophe; Pélégri, C.; Carlès, Michel; Boileau, Pascal

doi:10.1016/j.otsr.2012.12.010

Cited by 100 publications

(93 citation statements)

References 32 publications

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“…In our pilot study [3], the recurrent rate of shoulder instability was 24% after arthroscopic Bankart repair and 12% after the Latarjet procedure. To identify a relative difference, 80 patients would have to be included in each group (for a power of 80% and a risk of a Type I error of 5%).…”

Section: Power Analysismentioning

confidence: 63%

“…Nevertheless, the choice of a technique depends often on the surgeon's training or preferences. In a pilot study [3] comparing 51 patients undergoing arthroscopic Bankart repair to 51 patients undergoing the open Latarjet procedure, we found no differences between the approaches in terms of shoulder stability with the numbers available; however, we were concerned that insufficient followup duration and low statistical power might have contributed to the study's inability to detect a difference between these procedures.…”

Section: Introductionmentioning

confidence: 83%

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The Open Latarjet Procedure Is More Reliable in Terms of Shoulder Stability Than Arthroscopic Bankart Repair

Bessière

Trojani

Carlès

et al. 2014

Clinical Orthopaedics &Amp; Related Research

238

188

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Background Arthroscopic Bankart repair and open Latarjet bone block procedure are widely considered mainstays for surgical treatment of recurrent anterior shoulder instability. The choice between these procedures depends mainly on surgeon preference or training rather than published evidence. Questions/purposes We compared patients with recurrent posttraumatic anterior shoulder instability treated with arthroscopic Bankart or open Latarjet procedure in terms of (1) frequency and timing of recurrent instability, (2) risk factors for recurrent instability, and (3) patient-reported outcomes. Methods In this retrospective comparative study, we paired 93 patients undergoing open Latarjet procedures with 93 patients undergoing arthroscopic Bankart repairs over the same period for posttraumatic anterior shoulder instability by one of four surgeons at the same center. Both groups were comparable except that patients in the Latarjet group had more glenoid lesions and more instability episodes preoperatively. Minimum followup was 4 years (mean, 6 years; range, 4-10 years). Patients were assessed with a questionnaire, including stability, Rowe score, and return to sports. Recurrent instability was defined as at least one episode of recurrent dislocation or subluxation. Return to sports was evaluated using a 0% to 100% scale that patients completed after recovery from surgery. Various risk factors for recurrent instability were also analyzed. Results At latest followup, 10% (nine of 93) in the Latarjet group and 22% (20 of 93) in the Bankart group demonstrated recurrent instability (p = 0.026; odds ratio, 0.39; 95% CI, 0.17-0.91). Ten recurrences in the Bankart group (50%) occurred after 2 years, compared to only one (11%) in the Latarjet group. Reoperation rate was 6% and 7% in the Bankart and Latarjet groups, respectively. In both groups, patients younger than 20 years had higher recurrence risk (p = 0.019). In the Bankart group, independent factors predictive for recurrence were practice of competitive sports and shoulder hyperlaxity (ie, passive external rotation [ 85°in the contralateral uninjured shoulder). Although return to sports was not different between groups, the mean Rowe score was higher in the Latarjet group (78 versus 68, p = 0.018). Conclusions Patients who had the open Latarjet procedure had less recurrent instability and better Rowe scores over a mean 6-year followup. We now perform isolated arthroscopic Bankart repair for carefully selected patients, including patients with an Instability Severity Index Score of 3 or less. Level of Evidence Level III, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.

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Section: Power Analysismentioning

confidence: 63%

Section: Introductionmentioning

confidence: 83%

The Open Latarjet Procedure Is More Reliable in Terms of Shoulder Stability Than Arthroscopic Bankart Repair

Bessière

Trojani

Carlès

et al. 2014

Clinical Orthopaedics &Amp; Related Research

238

188

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“…Shah et al reported using canulated screws as a risk factor [16]. Three cases of recurrency in each group constituted 6.2% in OPEN and [24]. In OPEN group two of three cases were related with the graft osteolysis and one with traumatic graft fracture but these facts remained statistically insignificant.…”

Section: Complications Recurrence and Revisionsmentioning

confidence: 99%

Comparative study of open and arthroscopic coracoid transfer for shoulder anterior instability (Latarjet)—clinical results at short term follow-up

Kordasiewicz¹,

Małachowski²,

Kiciński³

et al. 2016

International Orthopaedics (SICOT)

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Results Average time of surgery was significantly shorter in ARTHRO than OPEN: respectively 110 and 120 minutes. The number of intra-operative complications was six (12.5%) in OPEN and five (8.1%) in ARTHRO. The results were comparable in both groups, with no significant difference between OPEN and ARTHRO group: satisfaction rate -96.8% and 91.9%, shoulder function -92.2% and 90%, Walch-Duplay score -83.9 and 76.7 respecively. A significant difference was reported in Rowe score: 87.8 in OPEN and 78.9 in ARTHRO. Another significant difference was found in the presence of Bsubjective apprehension^-a term referring to the subjective perception of instability with no signs of instability at clinical examination -28.7% in OPEN and 50% in ARTHRO. Range of motion in both groups were comparable, however patients in OPEN had significantly lower loss of external rotation in adduction to the side comparing to the contralateral shoulder: 7°versus 14°in ARTHRO. Recurrence was reported in three cases in each group: 6.2% in OPEN and 4.8% in ARTHRO. A revision surgery was performed in four patients (9.3%) in OPEN and six (9.7%) in ARTHRO. Radiographic evaluation showed a significantly lower rate (5%) of graft healing problems (fracture, non-union and osteolysis) after arthroscopic stabilisation, however a partial osteolysis of the proximal part of the bone block was significantly more frequent (53.5%). Conclusions The arthroscopic Latarjet stabilisation showed satisfactory and comparable results to open procedure. We recommend further investigation and development of arthroscopic technique.Level of evidence: III

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“…The rate of recurrent instability is 1.7-14.2 %, with a mean of 6.8 % [ 97 -100 ]. In a recent study, the rate of recurrent instability following a Latarjet reconstruction was two times lower than that following an arthroscopic Bankart repair [ 101 ]. In long-term follow-up, Lädermann et al reported recurrent instability or subluxation in only 2 of 117 (1.7 %) patients.…”

Section: Advantages and Pitfalls Complicationsmentioning

confidence: 95%

Traumatic Anterior Shoulder Instability: Part I. General Concepts and Proper Management

Lädermann

Benchouk

Denard

2015

Sports Injuries to the Shoulder and Elbow

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Coracoid bone block versus arthroscopic Bankart repair: A comparative paired study with 5-year follow-up

Abstract: Level IV (retrospective study).

Cited by 100 publications

References 32 publications

The Open Latarjet Procedure Is More Reliable in Terms of Shoulder Stability Than Arthroscopic Bankart Repair

The Open Latarjet Procedure Is More Reliable in Terms of Shoulder Stability Than Arthroscopic Bankart Repair

Comparative study of open and arthroscopic coracoid transfer for shoulder anterior instability (Latarjet)—clinical results at short term follow-up

Traumatic Anterior Shoulder Instability: Part I. General Concepts and Proper Management

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