Evidence brief
Arthroscopic vs Open Bankart Repair for Shoulder Instability
Similar recurrence rates for arthroscopic and open repair
Arthroscopic: better early ROM, less morbidity
Open: may be preferred for revision, bone loss, engaging Hill-Sachs
Contact athletes may have higher recurrence
Bone loss >25% may require Latarjet
Arthroscopic Bankart repair is effective for most primary anterior instability cases. Open surgery reserved for revision, significant bone loss, or specific patient factors.
Know instability workup: bone loss assessment (glenoid track concept, ISIS score). Arthroscopic Bankart for soft tissue lesion, <20% glenoid bone loss. Latarjet for: bone loss >20%, off-track Hill-Sachs, contact athletes. Discuss glenoid track concept.
Mohtadi NG et al. A randomized clinical trial comparing open and arthroscopic stabilization for recurrent traumatic anterior shoulder instability. Arthroscopy. 2005;21(11):1385.
Level I
Systematic review of RCTs or high-quality RCT