Outcomes of Open Bankart Repair Plus Inferior Capsular Shift Compared with Latarjet Procedure in Contact Athletes with Recurrent Anterior Shoulder Instability

Background: Open Bankart repair plus inferior capsular shift (OBICS) and Latarjet procedure (LA) are considered appropriate treatment alternatives for high-performance athletes. The purpose of this study was to evaluate the functional outcomes and recurrence rate of each surgery. Our hypothesis: there were no differences between the two treatments. Methods: A prospective cohort study was conducted with n=۹۰ contact athletes divided into two groups of ۴۵ patients. One group was treated with OBICS, and the other one with LA. The mean follow-up period was ۲۵ (۲۴-۳۲) months for the OBICS group and ۲۶ (۲۴-۳۱) months for the LA group. Primary functional outcomes of each group were assessed at baseline, six months, one year, and two years after surgery. The functional outcomes were also compared between the groups. The evaluation tools used were the Western Ontario Shoulder Instability score (WOSI) and the American Shoulder and Elbow Surgeons scale (ASES). In addition, recurrent instability and range of motion (ROM) were also evaluated.Results: In each group, significant changes were found in the WOSI score and ASES scale from pre-op to postop. However, there were no significant differences between the functional outcomes of the groups at the final follow-up (P-values ۰.۷۳ and ۰.۱۹). Three dislocations and one subluxation (۸.۸%) were reported in the OBICS group, and three subluxations were reported in the LA group (۶.۶%), revealing no significant differences between the groups (P=۰.۳۷). Moreover, there were no significant differences between preoperative and postoperative ROM in each group or in terms of external rotation (ER) and ER in ۹۰º abduction between the groups.  Conclusion: No differences were found between OBICS and LA surgery. Both procedures can be indicated according to the surgeon’s preference to reduce recurrence rates in contact athletes with recurrent anterior shoulder instability.Level of evidence: II

Keywords:

Inferior capsular shift , Glenoid bone defect , Open Bankart repair , Recurrent anterior shoulder dislocation