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. 2025 Aug 11:18:11795441251360805.
doi: 10.1177/11795441251360805. eCollection 2025.

Arthroscopic Bankart Repair Versus Open Latarjet Repair for Anterior Shoulder Instability: A Systematic Review and Meta-Analysis

Hashim Manea  1 , Muhammad Hassan Hafeez  2 , Bilal Ahmad  3 , Mohammed Ganim Musa  4 , Fatimah Abdullah Sulaiman  5 , Haider Anwar Ghalib  6 , Ralph Maroun  7 , Jamil Nasrallah  7 , Ahmed Adnan Al-Khafagi  8
Affiliations

Arthroscopic Bankart Repair Versus Open Latarjet Repair for Anterior Shoulder Instability: A Systematic Review and Meta-Analysis

Hashim Manea et al. Clin Med Insights Arthritis Musculoskelet Disord. .

Abstract

Background: Anterior shoulder instability is prevalent among young, active individuals, especially athletes. The optimal surgical intervention remains debated between Arthroscopic Bankart repair and Open Latarjet procedure.

Objectives: The Open Latarjet procedure results in lower recurrence rates and better functional outcomes compared with the Arthroscopic Bankart repair in patients with recurrent anterior shoulder instability, particularly those with significant glenoid bone loss and multiple preoperative dislocations.

Design: A systematic review and meta-analysis were conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Methods: Databases searched included PubMed, Google Scholar, and the Cochrane Library. Inclusion criteria encompassed studies comparing Arthroscopic Bankart repair with Open Latarjet procedure, reporting on recurrence rates, functional outcomes, and complications. Data extraction and risk of bias assessment were performed independently by 3 reviewers.

Results: 15 studies with 1636 patients were included. The Open Latarjet group exhibited significantly lower recurrence rates (4.2%) compared with the Arthroscopic Bankart group (11.8%). Functional scores (Rowe, WOSI, and ASES) were higher in the Latarjet group. Complication rates were similar, but the Bankart group had higher rates of redislocation and revision surgeries. Subgroup analyses revealed that patients with significant glenoid bone loss and multiple preoperative dislocations benefited more from the Latarjet procedure.

Conclusion: The Open Latarjet procedure offers superior outcomes for patients with recurrent anterior shoulder instability, especially those with significant bone loss and multiple dislocations. Surgical decision-making should be individualized, considering patient-specific factors.

Keywords: anterior shoulder instability; arthroscopic Bankart repair; complications; functional outcomes; meta-analysis; open Latarjet repair; recurrence rates.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

The image is a flow chart for the study selection process.
Figure 1.
The flow chart of the studies’ selection.
compare bankart and latarjet surgeries via odds ratios
Figure 2.
Forest plot clinical apprehension.
A table with Favors Bankart and Latarjet rows showing various studies’ data, and a forest plot graph comparing the mean difference between Bankart and Latarjet.
Figure 3.
Forest plot Rowe score.
compare effect size and weight of study and subgroup in this study
Figure 4.
Forest plot subjective shoulder value (%).
This forest plot visualizes the redislocation of odds ratios (ORs) between bank and layperson groups across 20 studies. The graph shows that the overall effect size is 4.32, indicating a favorable lean towards the bank group. Most studies have a Hounsfield (H) value ranging from 3.84 to 10.40, with a combined standard deviation of 7.82. The left side of the plot shows the favor ratio between bank and layperson groups, while the right side displays the ORs. The plot includes a diamond in the center indicating the overall effect size. The box plot summary provides additional statistical information, such as heterogeneity and the significance of the overall effect.
Figure 5.
Forest plot Redislocation.
The image is a forest plot detailing odds ratios comparing bankart injury to latarjet injury in ACL repairs, including heterogeneity values and a p-value for overall effect.
Figure 6.
Forest plot subluxation.
title: “Effect of BESSI test on the surgical outcome: Forest plot revision surgery due to recurrent instability
Figure 7.
Forest plot revision surgery due to recurrent instability.
The forest plot presents a detailed analysis of satisfaction levels in various studies conducted from 2014 to 2021. Each study is represented by a point estimate, reflecting the average satisfaction level across participants. Confidence intervals are also provided, indicating the precision of these estimates. The forest plot is a visual representation used in meta-analysis to compare the results from different studies and evaluate the overall effect size.
Figure 8.
Forest plot Satisfaction level (%).
A forest plot showing odds ratio and p-value for studies on risk factors associated with bone bankart lesions in CT scans.
Figure 9.
Forest plot significant bony Bankart lesion in CT (%).
{Image Content: Forest plot of Randomised Controlled Trials comparing visual analogue pain score between bank and latarjet groups, Study or Subgroup: (Randomised Controlled Trials), Bank Treatment Total SD Bank SD Mean Total SD Latarjet SD Mean Difference
Figure 10.
Forest plot visual analogue pain score.
""Football matches between clubs in a local league.
Figure 11.
Forest plot contact sports history.
Forest plot comparing the odds ratios of bankart and latarjet studies on Hill-Sachs lesions in 2021.
Figure 12.
Forest plot Hill-Sachs lesions in CT (%).
A forest plot and p-value of 0.87, 1.22, not estimating. Study of Subgroup Bankart Events vs Latarjet Events.
Figure 13.
Forest plot left side.
Forest plot right side showing Odds Ratio of different studies of Bankart and Latarjet events in the format.
Figure 14.
Forest plot right side.
Forest plot shows results of bankart vs larzet event rate comparison of various studies.
Figure 15.
Forest plot return to normal sports activity level (%).
the mean instability score in a study with 366 total participants using forest plot
Figure 16.
Forest plot mean instability severity index score.
The graph shows risk levels of different biases in randomized trials with color-coded categories for low, unclear, and high risk in categories like random sequence generation, allocation concealment, performance bias, etc.
Figure 17.
Risk of biases graph.
A risk of biases summary chart for 14 selected studies, showing positive and negative bias indications for various bias types.
Figure 18.
Risk of biases summary.
See this image and copyright information in PMC

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