Purpose
The purpose of this study was to perform a systematic review of the literature to
compare outcomes of revision anterior stabilization surgeries based on technique.
This study also sought to compare the impact of bone defects on outcomes.
Methods
A systematic review of the electronic databases PubMed, Cochrane Central Register
of Controlled Trials, and Scopus was performed in July 2012 and March 2013. Of 345
articles identified in the search, 17 studies with Level I to IV Evidence satisfied
the inclusion criteria and were analyzed according to PRISMA (Preferred Reporting
Items for Systematic Reviews and Meta-Analyses) guidelines. Recurrent instability
was defined as redislocation, resubluxation, or a positive apprehensive test after
revision surgery. Procedures were categorized as arthroscopic Bankart repair, open
Bankart repair, Bristow-Latarjet procedure, and other open procedures.
Results
In total, 388 shoulders were studied. Male patients comprised 74.1% of patients, 66.7%
of cases involved the dominant shoulder, the mean age was 28.2 years, and the mean
follow-up period was 44.2 months. The surgical procedures classified as “other open
procedures” had the highest rate of recurrent instability (42.7%), followed by arthroscopic
Bankart repair (14.7%), the Bristow-Latarjet procedure (14.3%), and open Bankart repair
(5.5%). Inconsistent reporting of bone defects precluded drawing significant conclusions.
Conclusions
A number of different procedures are used to address recurrent instability after a
primary operation for anterior shoulder instability has failed. There is significant
variability in the rate of recurrent instability after revision anterior shoulder
stabilization surgery.
Level of Evidence
Level IV, systematic review of Level I to IV studies.
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Article info
Publication history
Accepted:
November 19,
2013
Received:
November 2,
2013
Footnotes
The authors report the following potential conflict of interest or source of funding: L.G.M.F. receives support from Crile Summer Research fellowship grant for medical student research. M.H.J. receives support from Allergan and Genzyme.
Identification
Copyright
© 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
