Hovelius (2001) — Long-term results with the Bankart and Bristow-Latarjet procedures: recurrent shoulder instability and arthropathy.

Long-Term Results with the Bankart and Bristow-Latarjet Procedures: Recurrent Shoulder Instability and Arthropathy.

·J Shoulder Elbow Surg·2001·302 citations·Shoulder & Elbow

Hovelius (2001) compares open Bankart repair (26 shoulders, mean 17.5-year follow-up) versus Bristow-Latarjet procedure (30 shoulders, mean 15.1-year follow-up) for recurrent anterior shoulder instability, examining stability, function, patient satisfaction, and development of dislocation arthropathy at true long-term follow-up.

Study Snapshot

Design

Retrospective/prospective cohort

Setting: Two hospitals, Gävle and Falun, Sweden

Objective

Whether Bankart and Bristow-Latarjet procedures differ in stability and dislocation arthropathy

Outcome(s)

Recurrent instability and dislocation arthropathy at 15–20 years

Subjects

56 shoulders (52 patients): 26 Bankart, 30 Bristow-Latarjet

26 shouldersBankart repair per Rowe technique
30 shouldersBristow-Latarjet coracoid transfer

Inclusion

Recurrent anterior shoulder dislocation or subluxation

Exclusion

Multidirectional instability
Death before follow-up

Follow-up

Mean 17.5 y (Bankart); mean 15.1 y (Bristow)

Key Findings

Both procedures achieved statistically equivalent functional outcomes at long-term follow-up — Rowe score medians of 95 points and near-identical means (88 vs 87.6) — confirming that neither technique holds a meaningful functional advantage over the other
Bankart repair eliminated apprehension completely (0/25 shoulders) while Bristow-Latarjet left 8/29 shoulders with persistent subjective and/or objective apprehension — likely reflecting the unreplaced Bankart lesion and hardware impingement during external rotation rather than true recurrent instability
Bristow-Latarjet dramatically better preserved throwing ability in the dominant arm: 8/13 patients (62%) threw completely normally versus only 1/11 after Bankart, attributable to less external rotation loss (9.8° vs 14.6°) — a clinically decisive difference for overhead athletes
Dislocation arthropathy was more prevalent after Bankart repair but skewed toward mild grades; Bristow shoulders had fewer cases overall yet more moderate-to-severe involvement:
–Bankart: 16/26 shoulders affected — 14 mild, 2 moderate, 0 severe
–Bristow: 9/30 shoulders affected — 5 mild, 3 moderate, 1 severe
All 6 patients with moderate or severe arthropathy reported being very satisfied at follow-up — demonstrating that radiographic arthropathy grade is a poor surrogate for patient-reported outcome and should not independently drive surgical decision-making

Clinical Relevance

When counseling a throwing athlete or overhead worker with recurrent anterior instability, the Bristow-Latarjet is a legitimate option that better preserves external rotation and throwing function, while open Bankart repair offers superior apprehension elimination — both remain valid long-term choices, supporting the adage 'don't forget the Bristow-Latarjet' for appropriately selected patients.

Supplemental

Long-Term Results with the Bankart and Bristow-Latarjet Procedures: Recurrent Shoulder Instability and Arthropathy.

Hovelius, Malmqvist, et al.·J Shoulder Elbow Surg·2001·302 citations·Shoulder & Elbow

Long-Term Results with the Bankart and Bristow-Latarjet Procedures: Recurrent Shoulder Instability and Arthropathy.

Study Snapshot

Key Findings

Clinical Relevance

Related Articles

Long-Term Results with the Bankart and Bristow-Latarjet Procedures: Recurrent Shoulder Instability and Arthropathy.

Study Snapshot

Key Findings

Clinical Relevance

Related Articles

Long-Term Results with the Bankart and Bristow-Latarjet Procedures: Recurrent Shoulder Instability and Arthropathy.

Study Snapshot

Key Findings

Clinical Relevance

Related Articles

Long-Term Results with the Bankart and Bristow-Latarjet Procedures: Recurrent Shoulder Instability and Arthropathy.

Study Snapshot

Key Findings

Clinical Relevance

Related Articles