Latarjet vs. Bankart: Which Should You Choose?
Learn the differences between Latarjet and Bankart for shoulder instability.
Gabriele February
14 min. Jan 18, 2025
TL:DR:
● The Latarjet procedure is effective for athletes with glenoid bone defects ≥ 20%.
● The procedure allows a return to pre-operative sports activities.
● Safety and efficacy are confirmed by recent studies.
An innovative approach to shoulder stability
Shoulder instability is a common condition, especially among athletes, which can lead to recurrent dislocations and significant loss of function. Two of the most commonly used surgical procedures to address this problem are the Latarjet procedure and the Bankart repair. These techniques aim to restore shoulder stability, but differ in their approach and clinical indications.
Latarjet's intervention: an in-depth analysis
The Latarjet procedure, first described in 1954, has become a gold standard for the treatment of anterior shoulder instability, particularly in cases of significant glenoid bone loss. This procedure involves transferring the coracoid process to the anterior surface of the glenoid, creating a "lock" that stabilizes the joint. Recent studies, such as one published in the Journal of Orthopaedic Surgery and Research in 2024, have shown that for athletes with glenoid bone defects ≥ 20%, the Latarjet procedure can lead to excellent functional outcomes, with most patients returning to pre-operative levels of athletic activity (Wang et al., 2024).
The Latarjet procedure is based on two main components:
- Transfer of the Coracoid Process: During surgery, the coracoid process is harvested and fixed to the anterior aspect of the glenoid. This transfer not only fills the bone defect but also creates a mechanical "lock" that prevents anterior dislocation of the shoulder. This is particularly useful in patients with significant glenoid bone loss, as it provides structural stability.
- Tendon Transfer of the Conjunctiva Tendon: In addition to bone transfer, the Latarjet procedure also involves the use of the bicipital joint tendon. These tendons act as a sort of "sling" that reinforces the joint capsule and surrounding ligaments, improving the dynamic stability of the shoulder. This approach helps restore stability and function, reducing the risk of recurrence.
The technique has undergone significant evolution in recent years with the introduction of button fixation. This innovative technique offers several advantages over traditional methods, such as screw fixation. The literature suggests that functional results are comparable, if not superior, to those obtained with traditional fixation (Descamps et al., 2024; Laprus & Brzóska, 2023). The use of a button reduces the risk of hardware-related complications, such as screw migration or graft fracture, which are more common with traditional fixation techniques (Liang et al., 2024, pp. 691–695; Rossi et al., 2024). With growing evidence supporting this technique, it is likely to continue to gain popularity among orthopedic surgeons and patients.
Bankart repair: a valid alternative
Bankart repair is another common surgical technique for shoulder instability. This procedure focuses on repairing the damaged glenoid labrum without bone transfer. Although effective in many cases, its applicability is limited in patients with significant bone loss. The literature suggests that Bankart repair may have higher recurrence rates than Latarjet surgery, especially in athletes with a history of multiple dislocations (Han et al., 2024, pp. 666–671; Wang et al., 2024).
Effectiveness and safety of procedures
Both procedures have been shown to be safe and effective, but the choice between Latarjet and Bankart depends on several factors, including the extent of bone loss and the patient's medical history. For example, one study found that patients who underwent Latarjet had significantly lower recurrence rates than those who underwent Bankart repair, especially in the presence of bone defects (Descamps et al., 2024, p. 3635465241263590; Wang et al., 2024).
Clinical implications
In conclusion, the Latarjet procedure represents an effective solution for athletes with shoulder instability and significant bone defects. Its ability to restore stability and allow a return to sports activities is supported by recent scientific evidence. It is crucial that orthopedic surgeons carefully consider individual patient characteristics and specific clinical indications when deciding which procedure to adopt. A thorough understanding of the techniques and their implications is essential to ensure optimal results and reduce the risk of complications.
Final reflections
For patients suffering from shoulder instability, it is crucial to consult an experienced orthopedic surgeon who can provide a thorough assessment and recommendations based on the latest evidence. The choice between Latarjet surgery and Bankart repair should be individualized, taking into account the patient's specific needs and daily activities.
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