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Archives of Orthopaedic and Trauma Surgery

, Volume 135, Issue 4, pp 529–538 | Cite as

Effectiveness and safety of arthroscopic versus open Bankart repair for recurrent anterior shoulder dislocation: a meta-analysis of clinical trial data

  • Long Chen
  • Zhao Xu
  • Jing Peng
  • Fei Xing
  • Hong Wang
  • Zhou Xiang
Arthroscopy and Sports Medicine

Abstract

Purpose

To evaluate the effectiveness and safety of arthroscopic and open Bankart repair for recurrent anterior shoulder dislocation using meta-analysis of data from clinical trials.

Materials and methods

Cochrane Register of Controlled Trials, PUBMED and EMBASE were used to search and identify clinical trials that evaluated arthroscopic and open Bankart repair for recurrent anterior shoulder dislocation. Methodological qualities of studies were assessed by Cochrane Collaboration tool for assessing risk of bias and Newcastle–Ottawa Scale. Publication bias was detected using Begg’s test and Egger’s test.

Results

Sixteen trials involving 827 shoulders were included in the study. Based on Cochrane Collaboration tool for assessing risk of bias, three studies were rated as high quality and one study was rated as moderate quality among the randomized controlled trials. Another twelve case–control studies were rated as high quality based on Newcastle–Ottawa Scale. No significant publication bias was detected by Begg’s test or Egger’s test. Meta-analysis results indicated that arthroscopic repair has a significantly better recovery rate for external rotation at 90° of abduction, external rotation at side (P > 0.05) and forward flexion. However, arthroscopic repair had higher rates of recurrence and reoperation than open Bankart repair.

Conclusion

Meta-analysis of available randomized controlled trials and case–control studies demonstrated that arthroscopic repair and open Bankart repair were similar in safety. Arthroscopic repair resulted in better recovery of range of motion, but recurrence and reoperation rates were higher than open Bankart repair.

Keywords

Recurrent anterior shoulder dislocation Effectiveness Safety Arthroscopic Bankart repair Open Bankart repair Meta-analysis 

Notes

Conflict of interest

We have no conflicts of interest concerning this article and we did not receive any funding during this research.

References

  1. 1.
    Archetti Netto N, Tamaoki MJ, Lenza M, dos Santos JB, Matsumoto MH, Faloppa F, Belloti JC (2012) Treatment of Bankart lesions in traumatic anterior instability of the shoulder: a randomized controlled trial comparing arthroscopy and open techniques. Arthrosc J Arthrosc Relat Surg Off Publ Arthrosc Assoc N Am Int Arthrosc Assoc 28(7):900–908. doi: 10.1016/j.arthro.2011.11.03 CrossRefGoogle Scholar
  2. 2.
    Begg CB, Mazumdar M (1994) Operating characteristics of a rank correlation test for publication bias. Biometrics 50(4):1088–1101CrossRefPubMedGoogle 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(11):1730–1737. doi: 10.1177/0363546506288239 CrossRefPubMedGoogle Scholar
  4. 4.
    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 80-A(8):1108–1114Google Scholar
  5. 5.
    Cutts S, Prempeh M, Drew S (2009) Anterior shoulder dislocation. Ann R Coll Surg Engl 91(1):2–7. doi: 10.1308/003588409x359123 CrossRefPubMedCentralPubMedGoogle Scholar
  6. 6.
    Egger M, Davey Smith G, Schneider M, Minder C (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ (Clinical research ed) 315(7109):629–634CrossRefGoogle Scholar
  7. 7.
    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. Arthrosc J Arthrosc Relat Surg Off Publ Arthrosc Assoc N Am Int Arthrosc Assoc 20(5):456–462. doi: 10.1016/j.arthro.2004.03.001 CrossRefGoogle Scholar
  8. 8.
    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(6):1520–1527CrossRefPubMedGoogle Scholar
  9. 9.
    Wells GA, Shea B, O’Connel D (2012) The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp. Accessed 3 Mar 2015
  10. 10.
    Geiger DF, Hurley JA, Tovey JA, Rao JP (1997) Results of arthroscopic versus open Bankart suture repair. Clin Orthop Relat Res 337:111–117CrossRefPubMedGoogle Scholar
  11. 11.
    Godin J, Sekiya JK (2011) Systematic review of arthroscopic versus open repair for recurrent anterior shoulder dislocations. Sports Health 3(4):396–404. doi: 10.1177/1941738111409175 CrossRefPubMedCentralPubMedGoogle Scholar
  12. 12.
    Green MR, Christensen KP (1993) Arthroscopic versus open Bankart procedures: a comparison of early morbidity and complications. Arthrosc J Arthrosc Relat Surg Off Publ Arthrosc Assoc N Am Int Arthrosc Assoc 9(4):371–374CrossRefGoogle Scholar
  13. 13.
    Guanche CA, Quick DC, Sodergren KM, Buss DD (1996) Arthroscopic versus open reconstruction of the shoulder in patients with isolated Bankart lesions. Am J Sports Med 24(2):144–148CrossRefPubMedGoogle Scholar
  14. 14.
    Higgins JP, Green S (2011) Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0[updated March 2011]. The Cochrane Collaboration:www.cochrane-handbook.org
  15. 15.
    Hubbell JD, Ahmad S, Bezenoff LS, Fond J, Pettrone FA (2004) Comparison of shoulder stabilization using arthroscopic transglenoid sutures versus open capsulolabral repairs: a 5-year minimum follow-up. Am J Sports Med 32(3):650–654CrossRefPubMedGoogle Scholar
  16. 16.
    Jorgensen U, Svend-Hansen H, Bak K, Pedersen I (1999) Recurrent post-traumatic anterior shoulder dislocation–open versus arthroscopic repair. Knee Surg Sports Traumatol Arthrosc 7(2):118–124. doi: 10.1007/s001670050133 CrossRefPubMedGoogle Scholar
  17. 17.
    Karlsson J, Magnusson L, Ejerhed L, Hultenheim I, Lundin O, Kartus J (2001) Comparison of open and arthroscopic stabilization for recurrent shoulder dislocation in patients with a Bankart lesion. Am J Sports Med 29(5):538–542PubMedGoogle Scholar
  18. 18.
    Kartus J, Ejerhed L, Funck E, Kohler K, Sernert N, Karlsson J (1998) Arthroscopic and open shoulder stabilization using absorbable implants. A clinical and radiographic comparison of two methods. Knee Surg Sports Traumatol Arthrosc 6(3):181–188CrossRefPubMedGoogle Scholar
  19. 19.
    Kim SH, Ha KI (2002) Bankart repair in traumatic anterior shoulder instability: open versus arthroscopic technique. Arthrosc J Arthrosc Relat Surg Off Publ Arthrosc Assoc N Am Int Arthrosc Assoc 18(7):755–763CrossRefGoogle Scholar
  20. 20.
    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(2):244–254. doi: 10.2106/jbjs.e.01139 CrossRefPubMedGoogle Scholar
  21. 21.
    Mahirogullari M, Ozkan H, Akyuz M, Ugras AA, Guney A, Kuskucu M (2010) Comparison between the results of open and arthroscopic repair of isolated traumatic anterior instability of the shoulder. Acta Orthop Traumatol Turc 44(3):180–185CrossRefPubMedGoogle Scholar
  22. 22.
    Mohtadi NG, Bitar IJ, Sasyniuk TM, Hollinshead RM, Harper WP (2005) Arthroscopic versus open repair for traumatic anterior shoulder instability: a meta-analysis. Arthrosc J Arthrosc Relat Surg Off Publ Arthrosc Assoc N Am Int Arthrosc Assoc 21(6):652–658. doi: 10.1016/j.arthro.2005.02.021 CrossRefGoogle Scholar
  23. 23.
    Pulavarti RS, Symes TH, Rangan A (2009) Surgical interventions for anterior shoulder instability in adults. Cochrane Database Syst Rev. doi: 10.1002/14651858.CD005077.pub2 PubMedGoogle Scholar
  24. 24.
    Roberts SN, Taylor DE, Brown JN, Hayes MG, Saies A (1999) Open and arthroscopic techniques for the treatment of traumatic anterior shoulder instability in Australian rules football players. J Shoulder Elb Surgery Am Shoulder Elb Surg 8(5):403–409CrossRefGoogle Scholar
  25. 25.
    Rowe CR (1956) Prognosis in dislocations of the shoulder. J Bone Joint Surg Am 38-A(5):957–977PubMedGoogle Scholar
  26. 26.
    Sandow M, David H, Misan D (1996) Bankart repair using a suture anchor: a comparison between an arthroscopic and open technique. J Shoulder Elbow Surg 5(2):S88CrossRefGoogle Scholar
  27. 27.
    Simonet WT, Melton LJ 3rd, Cofield RH, Ilstrup DM (1984) Incidence of anterior shoulder dislocation in Olmsted County. Minn Clin Orthop relat Res 186:186–191Google Scholar
  28. 28.
    Sperber A, Hamberg P, Karlsson J, Sward L, Wredmark T (2001) Comparison of an arthroscopic and an open procedure for posttraumatic instability of the shoulder: a prospective, randomized multicenter study. J Shoulder Elb Surgery Am Shoulder Elb Surg [et al] 10(2):105–108. doi: 10.1067/mse.2001.112019 CrossRefGoogle Scholar
  29. 29.
    Sperling JW, Duncan SF, Torchia ME, O’Driscoll SW, Cofield RH (2005) Bankart repair in patients aged fifty years or greater: results of arthroscopic and open repairs. J Shoulder Elb Surgery Am Shoulder Elb Surg [et al] 14(2):111–113CrossRefGoogle Scholar
  30. 30.
    Steinbeck J, Jerosch J (1998) Arthroscopic transglenoid stabilization versus open anchor suturing in traumatic anterior instability of the shoulder. Am J Sports Med 26(3):373–378PubMedGoogle Scholar
  31. 31.
    Widjaja AB, Tran A, Bailey M, Proper S (2006) Correlation between Bankart and Hill-Sachs lesions in anterior shoulder dislocation. ANZ J Surg 76(6):436–438. doi: 10.1111/j.1445-2197.2006.03760.x CrossRefPubMedGoogle Scholar
  32. 32.
    Zacchilli MA, Owens BD (2010) Epidemiology of shoulder dislocations presenting to emergency departments in the United States. J Bone Joint Surg Am 92(3):542–549. doi: 10.2106/jbjs.i.00450 CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Long Chen
    • 1
  • Zhao Xu
    • 1
  • Jing Peng
    • 1
  • Fei Xing
    • 1
  • Hong Wang
    • 1
  • Zhou Xiang
    • 1
  1. 1.Department of Orthopaedics, West China HospitalSichuan UniversityChengduChina

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