Latarjet and allograft revision outperformed soft tissue repair

What the study found: Latarjet procedure and distal tibia allograft revision surgeries were associated with higher functional outcomes than soft tissue stabilization after failed arthroscopic Bankart repair in competitive athletes.
Why the authors say this matters: The authors conclude that, in this setting, revision procedure choice is associated with different postoperative functional outcomes, with Latarjet and distal tibia allograft performing better than soft tissue stabilization.
What the researchers tested: The researchers retrospectively reviewed patients who underwent revision surgery after a failed primary arthroscopic Bankart repair between 2000 and 2014. They compared revision arthroscopic Bankart repair, open Bankart repair, Latarjet procedure, and distal tibia allograft using shoulder outcome scores at a minimum of 2 years of follow-up.
What worked and what didn't: The revision arthroscopic Bankart repair and open Bankart repair groups had statistically lower postoperative American Shoulder and Elbow Surgeon scores, Single Assessment Numerical Evaluation scores, and Western Ontario Shoulder Instability Index scores than the Latarjet and distal tibia allograft groups. There was a significant difference in American Shoulder and Elbow Surgeon score between patients with glenoid bone loss under 25% and over 25%, but no significant difference in postoperative functional outcomes by Hill-Sachs lesion size or by labral and capsule pathology.
What to keep in mind: This was a retrospective cohort study with level III evidence. The abstract reports the included group was mostly male competitive athletes, and the follow-up period was a mean of 2.6 years.

Key points

• Latarjet procedure and distal tibia allograft had higher functional outcomes than soft tissue stabilization after failed arthroscopic Bankart repair.
• Revision arthroscopic Bankart repair and open Bankart repair scored lower than Latarjet and distal tibia allograft on three shoulder outcome measures.
• Patients with glenoid bone loss under 25% and over 25% had different American Shoulder and Elbow Surgeon scores.
• Hill-Sachs lesion size and labral/capsule pathology were not significantly linked to postoperative functional outcomes.
• The study reviewed 78 patients, mostly male, with a mean follow-up of 2.6 years.