Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 18, Issue 12, pp 1742–1747 | Cite as

A meta-analysis of open versus arthroscopic Bankart repair using suture anchors

  • M. Petrera
  • V. Patella
  • S. Patella
  • J. Theodoropoulos


Purpose of this study is to conduct a meta-analysis comparing the results of open and arthroscopic Bankart repair using suture anchors in recurrent traumatic anterior shoulder instability. Using Medline Pubmed, Cochrane and Embase databases we performed a search of all published articles. We included only studies that compared open and arthroscopic repair using suture anchors. Statistical analysis was performed using chi-square test. Six studies met the inclusion criteria. The total number of patients was 501, 234 suture anchors and 267 open. The rate of recurrent instability in the arthroscopic group was 6% versus 6.7% in the open group; rate of reoperation was 4.7% in the arthroscopic group vs. 6.6% in open (difference not statistically significant). The difference was statistically significant only in the studies after 2002 (2.9% of recurrence in the arthroscopic group vs. 9.2% in open; 2.2% of reoperation in the arthroscopic group vs. 9.2% in open). Results regarding function couldn’t be combined because of non-homogeneous scores reported in the original articles, but the arthroscopic treatment led to better functional results. Arthroscopic repair using suture anchors results in similar redislocation and reoperation rate compared to open Bankart repair; however, we need larger and more homogeneous prospective studies to confirm these findings.


Anterior shoulder instability Open Bankart repair Arthroscopic Bankart repair Suture anchors Recurrent shoulder dislocation 


Conflict of interest statement

The authors declare that they have no conflict of interest related to the publication of this manuscript and that no financial grants have been received for the study.


  1. 1.
    Bankart ASB (1938) The pathology and treatment of recurrent dislocation of the shoulder joint. Br J Surg 26:23–29CrossRefGoogle Scholar
  2. 2.
    Benedetto KP, Glotzer W (1992) Arthroscopic Bankart procedure by suture technique: indications, technique, and results. Arthroscopy 8:111–115CrossRefPubMedGoogle Scholar
  3. 3.
    Bottoni CR, Smith EL, Berkowitz MJ, Towle RB, Moore JH (2006) Arthroscopic versus open shoulder stabilization for recurrent anterior instability: a prospective randomized clinical trial. Am J Sports Med 34:1730–1737CrossRefPubMedGoogle Scholar
  4. 4.
    Burkhart SS, De Beer JF (2000) 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 16:677–694CrossRefPubMedGoogle Scholar
  5. 5.
    Caspari RB, Savoie FH (1991) Arthroscopic reconstruction of the shoulder: the bankart repair. In: McGinty JB et al (eds) Operative arthroscopy. Raven Press, New York, pp 507–515Google Scholar
  6. 6.
    Cole BJ, L’Insalata J, Irrgang J, Warner JJ (2000) Comparison of arthroscopic and open anterior shoulder stabilization. A two to six-year follow-up study. J Bone Joint Surg Am 82:1108–1114CrossRefPubMedGoogle Scholar
  7. 7.
    Dickinson JW, Devas MB (1957) Bankart’s operation for recurrent dislocation of the shoulder. J Bone Joint Surg Br 39:114–119Google Scholar
  8. 8.
    Dora C, Gerber C (2000) Shoulder function after arthroscopic anterior stabilization of the glenohumeral joint using an absorbable tack. J Shoulder Elbow Surg 9:294–298CrossRefPubMedGoogle Scholar
  9. 9.
    Fabbriciani C, Milano G, Demontis A, Fadda S, Ziranu F, Mulas PD (2004) Arthroscopic versus open treatment of Bankart lesion of the shoulder: a prospective randomized study. Arthroscopy 20:456–462CrossRefPubMedGoogle Scholar
  10. 10.
    Field L, Savoie F, Griffith P (1999) A comparison of open and arthroscopic Bankart repair [abstract]. J Shoulder Elbow Surg 8:195Google Scholar
  11. 11.
    Freedman KB, Smith AP, Romeo AA, Cole BJ, Bach BR Jr (2004) Open Bankart repair versus arthroscopic repair with transglenoid sutures or bioabsorbable tacks for recurrent anterior instability of the shoulder: a meta-analysis. Am J Sports Med 32:1520–1527CrossRefPubMedGoogle Scholar
  12. 12.
    Green MR, Christensen KP (1993) Arthroscopic versus open Bankart procedures: a comparison of early morbidity and complications. Arthroscopy 9:371–374CrossRefPubMedGoogle Scholar
  13. 13.
    Guanche CA, Quick DC, Sodergren KM, Buss DD (1996) Arthroscopic versus open reconstruction of the shoulder with isolated Bankart lesions. Am J Sports Med 24:144–148CrossRefPubMedGoogle Scholar
  14. 14.
    Hobby J, Griffin D, Dunbar M, Boileau P (2007) Is arthroscopic surgery for stabilization of chronic shoulder instability as effective as open surgery? A systematic review and meta-analysis of 62 studies including 3044 arthroscopic operations. J Bone Joint Surg Br 89:1188–1196CrossRefPubMedGoogle Scholar
  15. 15.
    Kang RW, Frank RM, Nho SJ, Ghodadra NS, Verma NN, Romeo AA, Provencher MT (2009) Complications associated with anterior shoulder instability repair. Arthroscopy 25:909–920CrossRefPubMedGoogle Scholar
  16. 16.
    Kim SH, Ha KI (2002) Bankart repair in traumatic anterior shoulder instability: open versus arthroscopic technique. Arthroscopy 18:755–763CrossRefPubMedGoogle Scholar
  17. 17.
    Lenters TR, Franta AK, Wolf FM, Leopold SS, Matsen FA 3rd (2007) Arthroscopic compared with open repairs for recurrent anterior shoulder instability. A systematic review and meta-analysis of the literature. J Bone Joint Surg Am 89:244–254CrossRefPubMedGoogle Scholar
  18. 18.
    Mohtadi NG, Bitar IJ, Sasyniuk TM, Hollinshead RM, Harper WP (2005) Arthroscopic versus open repair for traumatic anterior shoulder instability: a meta-analysis. Arthroscopy 21:652–658CrossRefPubMedGoogle Scholar
  19. 19.
    Morgan CD, Bodenstab AB (1987) Arthroscopic Bankart suture repair: techniques and early results. Arthroscopy 3:111–122CrossRefPubMedGoogle Scholar
  20. 20.
    Resch H, Povacz P, Wambacher M, Sperner G, Golser K (1997) Arthroscopic extra-articular Bankart repair for the treatment of recurrent anterior shoulder dislocation. Arthroscopy 13:188–200CrossRefPubMedGoogle Scholar
  21. 21.
    Rowe CR, Patel D, Southmayd WW (1978) The Bankart procedure: a long term end-result study. J Bone Joint Surg Am 60:1–16PubMedGoogle Scholar
  22. 22.
    Speer KP, Warren RF, Pagnani M, Warner JJ (1996) An arthroscopic technique for anterior stabilization of the shoulder with a bioabsorbable tack. J Bone Joint Surg Am 78:1801–1807PubMedGoogle Scholar
  23. 23.
    Wang C, Ghalambor N, Zarins B, Warner JJ (2005) Arthroscopic versus open Bankart repair: analysis of patient subjective outcome and cost. Arthroscopy 21:1219–1222CrossRefPubMedGoogle Scholar
  24. 24.
    Weber SC (1991) A prospective evaluation comparing arthroscopic and open treatment in the management of recurrent anterior glenohumeral dislocation. Orthop Trans 15:763Google Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • M. Petrera
    • 1
  • V. Patella
    • 2
  • S. Patella
    • 3
  • J. Theodoropoulos
    • 4
  1. 1.Division of Orthopaedic SurgeryMount Sinai HospitalTorontoCanada
  2. 2.2nd Unit of Orthopaedic and TraumaUniversity of Bari, PoliclinicoBariItaly
  3. 3.Biomechanics Laboratory, Department of Orthopaedic and Sports TraumaRizzoli Orthopaedic InstituteBolognaItaly
  4. 4.Division of Orthopaedic SurgeryMount Sinai HospitalTorontoCanada

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