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

Abstract

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. 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. 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. 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.