Summary

Both the techniques provide satisfactory clinical results, however, Bankart procedure was more expensive with 100% cosmetic satisfaction, whereas Latarjet procedure provided low recurrence with higher functional satisfaction.

Abstract

Purpose

The primary aim of this study was to compare the clinical outcomes of patients undergoing arthroscopic Bankart repair and open Latarjet procedure for recurrent dislocation of the shoulder. The secondary aims were to assess and compare the surgical cost, satisfaction and complications, including recurrence and infection.

Methods

We retrospectively evaluated patients who underwent either arthroscopic Bankart repair or open Latarjet procedure, having a minimum of 2-year follow-up. At the final follow-up, 41(male=32, female=9) patients in the Bankart group and 40(male=34 and female=6) patients in the Latarjet group were included in the study. Inclusion criteria were (1). Patients undergoing either arthroscopic Bankart repair with or without the remplissage procedure or open Latarjet procedure with a minimum follow-up of 2-year, and (2). All patients had an MRI and CT scan. The exclusion criteria were: (1). Revision surgery, (2). MRI and CT-scans were not available (3). Follow-up<2 years, (3). Associated with rotator cuff tears or SLAP lesions, (4). Previous surgery around the shoulder and (5) patients with neuromuscular disorders or epilepsy. Clinical outcomes were assessed using the ASES score [1], Rowe score [2], and Quick DASH score [3]. A self-constructed scale that consisted of satisfied and dissatisfied was used to measure the level of satisfaction. Any complications, including infection or redislocation, were recorded at every follow-up visit. Relevant statistical tests, using SPSS, were performed for data analysis.

Results

The average ASES score was 85-points and 87-points in the Bankart group and Latarjet group, respectively (p=0.388). Similarly, the average Rowe score was 84-points and 89-points in the Bankart group and Latarjet group, respectively (p=0.211). Moreover, the average quick DASH score was 10-points and 9-points in the Bankart and Latarjet groups, respectively(p=0.713). The average external rotation was 83 degrees in the Bankart group and 85 degrees in the Latarjet group(p=0.140). One-hundred percent of the patients were cosmetically satisfied in the Bankart group, whereas only 32(80%) patients were cosmetically satisfied in the Latarjet group(p=0.002). There was a significantly higher operating cost for arthroscopic Bankart repair compared to the open Latarjet procedure(p<0.001). Three patients had a recurrence in the Bankart group, whereas no recurrence occurred in the Latarjet group.

Conclusion

Both procedures provided satisfactory clinical and functional outcomes. Bankart procedure was more expensive with 100% cosmetic satisfaction, whereas Latarjet procedure provided low recurrence with higher functional satisfaction.

Keywords
Arthroscopy, Bankart repair, Latarjet procedure

References
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2. Rowe CR, Patel D, Southmayd WW. The Bankart procedure: a long-term end-result study. J Bone Joint Surg Am. 1978;60:1–16.
3. Hudak PL, Amadio PC, Bombardier C. Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand) [corrected]. The Upper Extremity Collaborative Group (UECG). Am J Ind Med. 1996;29:602–8.