Comparison Of Functional Outcomes of Arthroscopic Bankart Repair Vs Open Bristow-Latarjet Procedure for Shoulder Joint Instability
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Abstract
Background: Anterior shoulder instability predominantly affects collegiate athletes, with a notable incidence of 0.12 per 1000 athletic exposures. Acute dislocations pose an orthopedic emergency requiring immediate repositioning to prevent complications such as brachial plexus or artery compression, avascular necrosis of the humeral head, and chronic disability. Conservative therapy often precedes surgical intervention due to concerns over recovery time, discomfort, decreased range of motion, and high recurrence rates.
Objective: This study aims to compare the efficacy of Arthroscopic Bankart Repair and open Bristow-Latarjet Procedure in terms of pain reduction, return to normal activities, and improvement in Western Ontario Shoulder Instability (WOSI) score among patients with anterior shoulder joint instability.
Methods: A 12-month comparative study was conducted at Lahore General Hospital from April 2022 to April 2023, following ethical review board approval. Thirty-two patients aged 18–32, with severe unidirectional dislocation, consented and participated. They were divided into two groups: Group A underwent Arthroscopic Bankart Repair, and Group B underwent the open Bristow-Latarjet Procedure.
Results: The average age was 23 in Group B and 25 in Group A. Males comprised 80% of Group A and 68% of Group B. WOSI scores averaged 72 for Bankart and 76 for Latarjet. Rowe scores were 75 (Bankart) and 69 (Latarjet), with Quick DASH scores of 11 (Bankart) and 15 (Latarjet). External rotation was 77 degrees in Bankart and 73 degrees in Latarjet. Functional satisfaction was reported by 84.0% of Bankart and 11.7% of Latarjet patients. The cost of Latarjet was significantly lower than that of Bankart.
Conclusion: The open Latarjet procedure demonstrated higher functional satisfaction and lower operational costs compared to Arthroscopic Bankart Repair, which exhibited a higher recurrence rate. Given the economic constraints in a developing country like Pakistan, Latarjet may be a more viable option despite the non-invasive appeal of Bankart Repair.
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