Purpose
The aim of this study was to evaluate clinical outcome, rate of recurrence, complications,
and rate of postoperative osteoarthritis in patients with anterior shoulder instability
managed with Latarjet, Bristow, or Eden-Hybinette procedures.
Methods
A systematic review of the literature on management of anterior dislocation of the
shoulder with glenoid bony procedures was performed. A comprehensive search of PubMed,
MEDLINE, CINAHL, Cochrane, EMBASE, and Google Scholar databases using various combinations
of the keywords “shoulder,” “dislocation,” “treatment,” “Latarjet,” “Bristow,” “bone
loss,” “Eden-Hybinette,” “iliac,” “bone,” “block,” “clinical,” “outcome,” and “Bankart.”
The following data were extracted: demographics, bone defects and other lesions, type
of surgery, outcome measurement, range of motion (ROM), recurrence of instability,
complications, and osteoarthritis. A quantitative synthesis of all comparative studies
was performed to compare bone block procedures and Bankart repair in terms of postoperative
recurrence of instability and osteoarthritis.
Results
Forty-six studies were included and 3,211 shoulders were evaluated. The mean value
of the Coleman Methodology Score (CMS) was 65 points. Preoperatively, the injuries
detected most were glenoid bone loss and Bankart lesions. The Eden-Hybinette procedure
had the highest rate of postoperative osteoarthritis and recurrence. Pooled results
from comparative studies showed that the bone block procedures were associated with
a lower rate of recurrence when compared with Bankart repair (odds ratio [OR], 0.45;
95% confidence interval [CI], 0.28 to 0.74; P = .002), whereas there was no significant difference between the 2 groups in terms
of postoperative osteoarthritis (P = .79).
Conclusions
The open Bristow-Latarjet procedure continues to be a valid surgical option to treat
patients with anterior shoulder instability. Bone block procedures were associated
with a lower rate of recurrence when compared with the Bankart repair. The Eden-Hybinette
procedure has clinical outcomes very similar to the Bristow-Latarjet technique but
has a higher rate of postoperative osteoarthritis and recurrence. An arthroscopic
Bristow-Latarjet procedure seems to be better in terms of prevention of recurrence
and rehabilitation, but randomized studies are needed to reach definitive conclusions.
Level of Evidence
Level IV, systematic review of Level II, III, and IV studies.
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Article info
Publication history
Published online: June 04, 2014
Accepted:
April 3,
2014
Received:
February 20,
2014
Footnotes
The authors report that they have no conflicts of interest in the authorship and publication of this article.
Identification
Copyright
© 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
