Purpose
The purpose of this study was to compare functional outcome, return to sport, satisfaction,
postoperative recurrence, and complications in patients undergoing primary arthroscopic
Bankart repair with remplissage (ABR) to primary Latarjet.
Methods
A multicenter retrospective study was performed on patients undergoing primary ABR
or open Latarjet between 2013 and 2019 who had a minimum 2-year follow-up. Baseline
and two-year range of motion (ROM), patient-reported outcomes (PROs: Western Ontario
Shoulder Instability Index [WOSI], Single Assessment Numeric Evaluation [SANE], and
visual analog scale [VAS] for pain) recurrence, return to sport, satisfaction, and
complications were reviewed.
Results
This study included 258 patients, including 70 ABRs and 188 Latarjet procedures. Baseline
demographics, ROM, and PROs were similar. Mean preop glenoid bone loss (GBL) (12.3%
± 10.9% vs 7.6% ± 9%; P < .001) and off-track lesions (23% vs 13%; P = .046) were higher in the ABR group, while preoperative GBL range was similar (0-42%
vs 0-47%). Changes in the VAS (1.9 vs 0.9; P = .019) and WOSI (1096 vs 805; P < .001) were improved in ABR. The percentage of patients who achieved a minimal clinically
important difference was improved in WOSI for ABR and PASS for ABR in SANE, VAS, and
WOSI scores. The ABR cohort reported worse changes in external rotation (ER) (−4°
vs +19°; P < .001). Return to sport among overhead and contact athletes favored ABR (91.5% vs
72.7%; P = .007). Satisfaction and recurrent dislocation were similar. Surgical complications
were observed in 0% of ABR cases, compared to 5.9% in the Latarjet group.
Conclusion
Primary ABR resulted in 2-year functional outcomes that were as good or superior to
primary Latarjet, with higher return to sport for overhead and contact activities,
fewer complications, and comparably low recurrence rates, even despite greater bipolar
bone loss in the ABR cohort. However, this comes at the expense of decreased external
rotation, which may be considered in individual patients.
Level of Evidence
III, retrospective comparative study.
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Article Info
Publication History
Published online: April 07, 2022
Accepted:
March 20,
2022
Received:
November 26,
2021
Publication stage
In Press Journal Pre-ProofFootnotes
The authors report the following potential conflicts of interest or sources of funding: P.N. reports personal fees from Arthrex , outside the submitted work. J.B. is a paid consultant for Arthrex , SBM, and Move-Up. He receives royalties from Move-Up. He is president of the Francophone Society of Arthroscopy. A.L. is a paid consultant for Arthrex, Stryker, and Medacta. He receives royalties from Stryker. He is president of the FORE Foundation and founder of BeeMed. P.J.D. reports grants from Arthrex, Inc., during the conduct of the study; personal fees and other from Arthrex , Inc., outside the submitted work. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Identification
Copyright
© 2022 by the Arthroscopy Association of North America
