Arthroscopic Versus Open Bankart Repairs in Recurrent Anterior Shoulder Instability: A Systematic Review of the Association Between Publication Date and Postoperative Recurrent Instability in Systematic Reviews.

PURPOSE

To systematically review the results of systematic studies regarding open versus arthroscopic Bankart repairs for recurrent anterior shoulder instability and quantitatively analyze the effect of primary-literature publication dates on reported outcomes in these systematic studies.

METHODS

A systematic search was conducted to identify systematic studies reporting outcomes of both arthroscopic and open Bankart repairs for recurrent anterior shoulder instability. Patient-reported outcome measures, recurrent instability rates, definitions of instability, and procedure types reported by included study characteristics were qualitatively analyzed. Correlation coefficient analyses were performed to investigate if a systematic study's proportion of included primary literature published after 1999, 2000, 2001, or 2002 affected that study's reported mean difference in instability recurrence between open and arthroscopic procedures. The Assessment of Multiple Systematic Reviews criteria were used to assess the risk of bias of the included studies.

RESULTS

Of 130 identified articles, 6 met the inclusion criteria. Patient-reported outcome measures were poorly reported. Among mean differences in instability recurrence rates, the results were indeterminate: Although 5 studies reported arthroscopic surgical procedures as having a higher recurrence rate, only 1 reported a statistically significant difference. Within the 5 included systematic reviews reporting the number of included studies, 37 of 56 observations were published after 2000. The proportion of studies published after 2000 (Pearson r = 0.88, P = .052) was positively associated with differences in instability recurrence rates between open and arthroscopic procedures.

CONCLUSIONS

Systematic studies that included newer studies (published after 2000) were associated with more favorable arthroscopic outcomes.

LEVEL OF EVIDENCE

Level IV, systematic review of Level III and IV studies.