A recently published study carried out by a team including London Shoulder Specialist Mr Ali Narvani has assessed the different treatment options for recurrent anterior instability. Up until now, there has been little research carried out into the effectiveness of existing treatments.
Here, we will look at what the recent study revealed and what it means for patients.
Understanding the recent study
Published in the American Journal of Sports Medicine, this recent study pooled data from 2018, across seven cohort studies. It compared Latarjet and Bankart treatments for anterior shoulder instability. Both continuous data and dichotomous data were pooled from a total of 3,275 patients.
Results showed that the Bankart technique had an increased risk of recurrence and re-dislocation. However, it had a decreased risk of infection compared to the Latarjet technique. Both had a similar Rowe score, revision, and haematoma formation rates.
What is the Bankart technique?
During the Bankart procedure, the overstretched or torn labrum and capsule are repaired deeper within the shoulder joint. The surgery is usually performed arthroscopically, but an open procedure can also be used. The method chosen for your repair will be discussed with you during your consultation.
In most cases, the surgeon uses a nerve block during the surgery. This helps to completely numb the area for up to a few hours. Painkillers will be provided to ease the pain after the procedure to make the recovery more comfortable.
What is the Latarjet technique?
The Latarjet technique focuses on relocating a piece of bone, complete with an attached tendon, to the joint of the shoulder. It is commonly performed on patients with recurrent instability that is brought on by a Bankart lesion. This procedure is often recommended for patients where a labrum repair doesn’t fix the damage within the joint.
Understanding shoulder instability
Instability in the shoulder arises when the upper arm bone is pushed out of its socket. It can happen due to an injury or from overuse. Shoulders are susceptible to repeated dislocations after they have been dislocated once. If it keeps happening, it is referred to as chronic instability.
Shoulder instability may be directional, or multidirectional. With directional instability, it can affect the anterior or posterior of the joint. With multidirectional instability, both the front and the back of the joint are affected. Anterior instability tends to be the most common form patients experience. This is likely since the capsule of the joint is weaker in the front of the joint.
Treatment for shoulder instability will depend upon the location and cause of the issue. As the new study suggests, the Latarjet procedure is more effective at reducing the likelihood of recurrence. However, for some patients the Bankart procedure may be the better option.
Call +44 (0) 203 195 2442 to book a consultation to discover the best course of treatment for your shoulder instability today.