Arthroscopic Bankart versus the open Latarjet procedure for anterior–inferior shoulder instability in young males: a randomised controlled trial with minimum 5-year follow-up
British Journal of Sports Medicine · 13 Oct 2026
† Impact is the editorial-priority score. All scores are out of 100. Clinical is a stored clinical-importance score from the earlier method; it has not been recalculated.
Why it matters
It is the only randomised comparison of the two main stabilisation operations in the highest-risk group of shoulder dislocators, and it directly informs the Bankart versus Latarjet decision often tested on boards and debated in clinic.
The evidence
This Finnish multicentre randomised trial assigned 122 young men (aged 16 to 25) with recurrent traumatic anterior shoulder instability to either arthroscopic Bankart repair or open Latarjet coracoid transfer and followed them for 5 years. Redislocation occurred in 16 of 62 Bankart patients (26%) versus 3 of 60 Latarjet patients (5%), and 9 Bankart patients needed revision surgery compared with none after Latarjet. Shoulder instability scores (WOSI) improved in both groups with no meaningful difference between them (mean difference about 1 point, well under the 13-point clinically important threshold).
A coherent primary effect estimate is unavailable. Clinical relevance does not estimate treatment benefit.
Why this rigour score?
Multicentre RCTDesign starting point: 63.4
Raised the score
- Adequately powered+6
- Concealed allocation+5.1
Lowered the score
- More patients lost than the result can absorb−6.8
- 29% loss to follow-up−6.7
Methods at a glance
Recorded assessment- Outcome assessors blindedNot reported
- Allocation concealedMet
- Random sequence generatedMet
- Intention-to-treat analysisMet
- Adequate statistical powerMet
- Prospective registrationMet
Not reported does not mean not done. Checks have different weights; this is not a count of boxes ticked.
See the full score breakdown
- Study design starting point
- 63.4
- Concealed allocation
- +5.1
- Random sequence generation
- +2.5
- Compared against current standard of care
- +3.4
- Intention-to-treat analysis
- +3.4
- 29% loss to follow-up
- −6.7
- Adequately powered
- +6
- Prospectively registered
- +5.1
- Fragility index 4 (subspecialty median 2)
- +0.8
- More patients lost than the result can absorb
- −6.8
- Final rigour score rounded
- 76 / 100
Study design sets the starting point and a ceiling of 100. Recorded methods then adjust the score. Points are shown to one decimal place; the final score uses unrounded values.
Checklist from the stored appraisal. “Not met” describes the recorded criterion; it does not always produce a deduction. This overview supports reading the full study.
For journal club
1.For a 19-year-old male contact athlete with recurrent anterior dislocations and little bone loss, how would a roughly 1 in 4 versus 1 in 20 five-year redislocation risk change the operation you recommend and how you counsel him?
2.Given similar patient-reported scores but very different redislocation and revision rates, which outcomes should matter most when discussing surgery with a young patient, and how should hyperlaxity or competitive sport goals shift the choice?
Original publication title
Arthroscopic Bankart versus the open Latarjet procedure for anterior–inferior shoulder instability in young males: a randomised controlled trial with minimum 5-year follow-up