The management of recurrent anterior glenohumeral instability in the presence of subcritical glenoid bone loss (GBL), defined as 20% or less, continues to be a challenging and debated issue in orthopedic surgery. Treatment options such as arthroscopic Bankart with remplissage (ABR+R) and the open Latarjet procedure are frequently considered, but direct comparisons in this specific patient population are lacking. This study, written by colleagues of Dr. Okoroha, aims to clarify these treatment approaches by comparing the outcomes of ABR+R and Latarjet, with a particular focus on recurrence of instability and the need for reoperation in both primary and revision procedures. Through a retrospective analysis, the study explores whether ABR+R results in higher rates of recurrent instability and revision surgeries compared to Latarjet, offering critical insights into decision-making for patients with subcritical GBL.
Study Highlights:
Patient Demographics: 108 patients undergoing Arthroscopic ABR + R or an open Latarjet procedure. Patients with connective tissue disorders, significant glenoid bone loss (greater than 20%), less than two years of follow-up, or incomplete data were excluded from the study.
Followup: The average followup time was 4.3 years.
Positive Outcomes: In both primary surgeries (p=0.60) and revision surgeries (p=0.28), the rates of instability were similar between the two procedures. The p-values show no significant difference between the techniques. Similar results were found for reoperation rates between the two procedures, with no significant differences in either the primary setting (p=0.06) or the revision setting (p=1.00).
Conclusion
In conclusion, this study found no significant differences in recurrent instability or reoperation rates between arthroscopic Bankart with remplissage (ABR+R) and the open Latarjet procedure for patients with subcritical glenoid bone loss (≤ 20%) in both primary and revision settings. Additionally, ABR+R demonstrated improved subjective shoulder value (SSV), range of motion (ROM), and internal rotation strength in primary cases. These results suggest that ABR+R is a safe and effective option for selected patients with subcritical GBL, offering comparable outcomes to Latarjet while preserving shoulder function. Patients who experience shoulder pain should be evaluated by an orthopedic surgeon urgently for treatment options.
At Mayo Clinic, located in Minneapolis, Minnesota, we are committed to providing personalized care and innovative treatments to help athletes reach their full potential. To learn more about shoulder instability, shoulder labral tears, and shoulder labral repair, schedule a consultation with Dr. Okoroha today. Seeing patients from Minneapolis, St. Paul, Plymouth, Edina, Minnetonka, Rochester, and Minnesota ensures that athletes receive specialized care aimed at maximizing their athletic performance and long-term shoulder health.
