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

Document Type : RESEARCH PAPER


Sanatorio Allende, Cordoba, Argentina


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 
Methods: A prospective cohort study was conducted with n=90 contact athletes divided into two groups of 45 patients. 
One group was treated with OBICS, and the other one with LA. The mean follow-up period was 25 (24-32) months for 
the OBICS group and 26 (24-31) 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 
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 0.73 and 0.19). Three dislocations and one subluxation (8.8%) were reported in the OBICS group, and three 
subluxations were reported in the LA group (6.6%), revealing no significant differences between the groups (P=0.37). 
Moreover, there were no significant differences between preoperative and postoperative ROM in each group or in terms 
of external rotation (ER) and ER in 90º 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


Main Subjects

1. Yamamoto N, Kijima H, Nagamoto H, et al. Outcome of
Bankart repair in contact versus non-contact athletes.
Orthop Traumatol Surg Res. 2015; 101(4):415-9.
2. Sanborn L, Arciero RA, Yang JS. Don’t forget the open
Bankart. Look at the evidence. Ann Joint. 2017; 2:67.
3. Murphy AI, Hurley ET, Hurley DJ, Pauzenberger L,
Mullett H. Long-term outcomes of the arthroscopic
Bankart repair: a systematic review of studies at
10-year follow-up. J Shoulder Elbow Surg. 2019;
28(11):2084-2089. doi: 10.1016/j.jse.2019.04.057.
4. Bankart AS, Cantab MC. Recurrent or habitual
dislocation of the shoulder-joint.1923. Clin Orthop
Rel Res. 1993: (291):3-6.
5. Altchek DW, Warren RF, Skyhar MJ, Ortiz G.
T-plasty modification of the Bankart procedure for
multidirectional instability of the anterior and inferior
types. J Bone Joint Surg Am. 1991; 73(1):105-112.
6. Mohtadi NGH, Bitar IJ, Sasyniuk TM, Hollinshead
RM, Harper WP. Arthroscopic versus open repair
for traumatic anterior shoulder instability: A
meta-analysis. Arthroscopy. 2005; 21(6):652-8.
7. Chen L, Xu Z, Peng J, Xing F, Wang H, Xiang Z.
Effectiveness and safety of arthroscopic versus
open Bankart repair for recurrent anterior shoulder
dislocation: a meta-analysis of clinical trial data.
Arch Orthop Trauma Surg 2015; 135(4):529-38.
8. Berendes TD, Wolterbeek R, Pilot P, Verburg H, Slaa
RL. The open modified Bankart procedure: outcome at
follow-up of 10 to 15 years. J Bone Joint Surg Br 2007;
89(8):1064-8. doi:10.1302/0301-620X.89B8.19280.
9. Balg F, Boileau P. The instability severity index score.
A simple pre-operative score to select patients
for arthroscopic or open shoulder stabilisation.
J Bone Joint Surg Br. 2007; 89(11):1470-7.
10.White AE, Patel NK, Hadley CJ, Dodson CC. An
Algorithmic Approach to the Management of
Shoulder Instability. J Am Acad Orthop Surg Glob
Res Rev 2019; 23;3(12):e19.00168. doi:10.5435/
11.Merrill CA, Arciero R. Open Bankart Repair: A
Reproducible Technique. Operative Techniques in
Sports Medicine. 2019; (27), 1:42-48. doi:10.1053/j.
12.Wong SE, MD, Friedman LG, Garrigues GE.
Arthroscopic Latarjet: Indications, Techniques, and
Results. Arthroscopy. 2020; 36(8):2044-2046. doi:
13.Rollick NC; Ono Y, Kurji HM, et al. Long-term outcomes
of the Bankart and Latarjet repairs: a systematic
review. Open Access J Sports Med. 2017; 15; 8:97-105.
14.Wellmann M, De Ferrari H, Smith T, et al. Biomechanical
investigation of the stabilization principle of the
Latarjet procedure. Arch Orthop Trauma Surg. 2012;
132(3):377-86. doi:10.1007/s00402-011-1425-z.
15.Burkhart SS, De Beer JF. Traumatic glenohumeral
bone defects and their relationship to failure of
arthroscopic Bankart repairs: significance of the
inverted-pear glenoid and the humeral engaging
Hill-Sachs lesion. Arthroscopy 2000; 16(7):677-94.
16.Moroder P, Odorizzi M, Pizzinini S, Demetz E, Resch
H, Moroder P. Open Bankart repair for the treatment
of anterior shoulder instability without substantial
osseous glenoid defects: results after a minimum
follow-up of twenty years. J Bone Joint Surg Am. 2015;
2, 97(17):1398-405. doi: 10.2106/JBJS.N.01214.
17.Uchiyama Y, Handa A, Shimpuku E, et al. Open
Bankart repair plus inferior capsular shift versus
arthroscopic Bankart repair without augmentations
for traumatic anterior shoulder instability: A
prospective study. J Orthop Surg (Hong Kong). 2017;
18.Fabre T, Abi-Chahla ML, Billaud A, Billaud A, Geneste
M, Durandeau A. Long-term results with Bankart procedure: A 26-year follow-up study of 50 cases.
J Shoulder Elbow Surg. 2010; 19(2):318-23. doi:
19.Xu Y, Wu K, Ma Q, et al. Comparison of clinical and
patient-reported outcomes of three procedures for
recurrent anterior shoulder instability: arthroscopic
Bankart repair, capsular shift, and open Latarjet. J
Orthop Surg Res. 2019; 18, 14(1):326. doi:10.1186/
20.An V, Sivakumar B, Phan K, Trantalis J. A systematic
review and meta-analysis of clinical and patientreported outcomes following two procedures for
recurrent traumatic anterior instability of the
shoulder: Latarjet procedure vs. Bankart repair.
J Shoulder Elbow Surg. 2016; 25(5):853-63. doi:
21.Nourissat G, Neyton L, Metais P, et al. Functional
outcomes after open versus arthroscopic Latarjet
procedure: A prospective comparative study.
Orthopaedics & Traumatology: Surgery & Research.
Orthop Traumatol Surg Res. Orthop Traumatol
Surg Res 2016; 102(8S):S277-S279. doi:10.1016/j.
22.Mohtadi NGH, Chan DS, Hollinshead RM, et al.
Randomized Clinical Trial Comparing Open and
Arthroscopic Stabilization for Recurrent Traumatic
Anterior Shoulder Instability Two-Year Follow-up
with Disease-Specific Quality-of-Life Outcomes. J Bone
Joint Surg Am. 2014; 96(5):353-60. doi: 10.2106/
23.Domos P, Lunini E, Walch G. Contraindications
and complications of the Latarjet procedure.
Shoulder Elbow. 2018; 10(1):15-24. doi: 10.1177/
24.Shah AA, Butler RB, Romanowski J, Goel D, Karadagli
D, Warner JJ. Short-term complications of the Latarjet
procedure. J Bone Joint Surg Am. 2012; 21; 94(6):495-
501. doi:10.2106/JBJS.J.01830.
25.Di Giacomo G, Costantini A, Gasperis N, et al. Coracoid
graft osteolysis after the Latarjet procedure for
anteroinferior shoulder instability: a computed
tomography scan study of twenty-six patients.
J Shoulder Elbow Surg. 2011; 20(6):989-95.
26.Walch G and Boileau P. Latarjet-Bristow procedure for
recurrent anterior instability. Tech Shoulder Elbow
Surg. 2000; 1(4):256-261.
27.Rossi LA, Tanoira I, Gorodischer T, Pasqualini I,
Ranalletta M. High Variability in Functional Outcomes
and Recurrences Between Contact Sports After
Arthroscopic Bankart Repair: A Comparative Study
of 351 Patients With a Minimum 3-Year Follow-Up.
Arthrosc Sports Med Rehabil. 2020; 2(5): e575–e581.