Return to play and recurrent instability rates in open versus arthroscopic anterior shoulder stabilisation in the contact and collision athlete: A systematic review.

PURPOSE: The purpose of this systematic review is to compare return-to-play and recurrence rates in collision and contact athletes who undergo open or arthroscopic Bankart repair. METHODS: The literature search was performed based on the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines, using PubMED, Cochrane Library and Embase in April 2025. Cohort studies comparing the open and arthroscopic Bankart repair for anterior shoulder instability in contact/collision athletes were included. Clinical outcomes were compared, with all statistical analysis performed using Review Manager Version 5.3. RESULTS: Six clinical trials with 319 athletes were included. There was a statistically significant difference in favour of open Bankart repair for recurrent instability (7.2% vs. 17.9%, I2 = 0%, p = 0.008). There was no statistically significant difference in return to play (91.2% vs. 92.6%, I2 = 0%, p = 0.88), or return at pre-injury level (44.1% vs. 33.3%, I2 = 14%, p = 0.19). Among those undergoing open Bankart repair, the best-case and worst-case analysis revealed that the recurrence rate could be between 8% and 9% in those able to return to play. Among those undergoing arthroscopic Bankart repair, the best-case and worst-case analysis revealed that the recurrence rate could be between 23.8% and 31% in those able to return to play. CONCLUSIONS: Contact or collision athletes undergoing anterior shoulder stabilisation have lower rates of recurrent instability when with an open Bankart repair. However, similar return-to-play rates are seen with either approach. LEVEL OF EVIDENCE: Level III.

Duke Scholars

Author Jonathan F Dickens Orthopaedic Surgery

Author Dean Curtis Taylor Orthopaedic Surgery