Primary Latarjet procedure versus Latarjet in the setting of previously failed Bankart repair: a systematic review

Abstract

Objectives: The purpose of this study is to systematically review the comparative studies in the literature tocompare the outcomes of the Latarjet procedure in the setting of a previously failed Bankart repair versus thoseundergoing the Latarjet procedure as a primary surgery for anterior shoulder instability.Methods: A systematic search in Pubmed, EMBASE, and The Cochrane Library databases was carried out accordingto the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Cohort studies comparingoutcomes in the Latarjet procedure as a primary surgery versus the Latarjet procedure in the setting of a previouslyfailed Bankart repair were included.Results: Ten studies with 1913 patients were included. There was a significantly lower rate of recurrent instabilityin those with a Latarjet procedure as a primary surgery (4.8% vs 12.1%, p ¼ 0.007). There was also a significantlylower rate of complications with the Latarjet procedure as a primary surgery (6.2% vs 10.2%, p ¼ 0.03).Furthermore, there was a significant difference in the rate of revision surgery in favour of the Latarjet procedureas a primary surgery (4.8% vs 10.9%, p ¼ 0.02). However, there were similar rates of redislocations (2.8% vs3.4%, p ¼ 0.82) and return to play (67.7% vs 78.5%, p ¼ 0.30) between the two cohorts.Conclusion: This study found that the Latarjet procedure as a revision procedure for a previously failed Bankartrepair resulted in higher rates of complications, recurrent instability, and revisions than the Latarjet procedureperformed as a primary procedure.