Comparative outcomes of the Latarjet procedure and arthroscopic Bankart repair: A systematic review and meta-analysis of recurrence rates and clinical scores

Abstract

Saleh M. Kardm*, Ziad Ahmed Alanazi, Abdulrahman Saad M Alqahtani, Abdullah Ibrahim Alshafi, Aws Mubarak Algahtany, Abdulaziz Turki R Alhadrami, Hussam Sulaiman AlQifari, Mohammed Abdullah Almutawa, Jalal Mohammed Alsayyad, Ali Mohammed Aalqahtani, Hussain Ali Bin Nahi, Tariq Abdullah S Aldugman and Wael M. Alzahrani

Background: Recurrent shoulder instability can present a significant challenge in orthopedic surgery, affecting patients' quality of life. Arthroscopic Bankart repair (ABR) and the Latarjet procedure are two widely utilized surgical techniques for stabilization, each with distinct advantages and limitations. However, the debate regarding the standard intervention in anterior shoulder dislocation still remains. Aim: We conducted this systematic review and meta-analysis to compare the clinical and functional outcomes of ABR vs. arthroscopic Latarjet (AL) and open Latarjet (OL).

Methods: We conducted a systematic search through PubMed, Cochrane, Scopus, and Web of Science databases until January 2025, including all the studies that compare ABR vs. the Latarjet procedure (OL or AL). We conducted a meta-analysis using the Review Manager software for statistical analysis. We used risk ratio (RR) and its 95% confidence interval (CI) to compare the dichotomous outcomes while using mean difference (MD) for continuous outcomes, applying the random effect model.

Results: Twenty studies met our predefined strict criteria and were included in the meta-analysis. This study demonstrated that the Latarjet procedure (OL and AL) significantly reduced recurrence rates compared to ABR (RR = 2.84, 95% CI: 1.74–4.62, P < 0.0001). Subgroup analyses highlighted consistent findings favoring the Latarjet procedure in non-athletes (RR = 3.14) and adolescents (RR = 7.79). However, the advantage was not statistically significant among athletes (RR = 2.42, P = 0.1). Additionally, the Latarjet procedure had a lower risk of revision surgeries (RR = 3.9, 95% CI: 1.74– 8.72, P = 0.0009), particularly in non-athletes and younger populations. While the Rowe score favored Latarjet significantly (MD = -4.51, P = 0.001), the ASES and SSV scores showed no statistical difference between the two procedures. 

Conclusion: The Latarjet procedure demonstrates superiority over Bankart repair in reducing recurrence rates and revision surgeries, particularly in nonathletes, adolescents, and adults. These findings suggest that the Latarjet procedure may be the preferred surgical intervention for instability in these populations. However, high heterogeneity across studies, especially in clinical scores like ASES and SSV, underscores the need for further research to confirm these outcomes and address variability.