When an Isolated Bankart Repair is Not Enough: Comparing Latarjet Versus Augmentation with Remplissage.

purpose of reviewIncreased recurrence rates following isolated arthroscopic Bankart repair, particularly in young, high-risk athletes, have prompted adoption of adjunctive surgical strategies. Two commonly utilized techniques are arthroscopic Bankart repair with Remplissage and the Latarjet procedure. Despite widespread use of both options, the optimal indications remain debated. This review synthesizes contemporary evidence regarding indications, clinical scenarios and outcomes, recurrence risk, return to sport and complication profiles following these procedures. RECENT

findingsBoth arthroscopic Bankart repair with remplissage and Latarjet demonstrate excellent outcomes, providing return to sport rates exceeding 80% with recurrence rates ranging from 5 to 10% and 0-5% for the remplissage and Latarjet, respectively [1-3]. Overall complication rates following remplissage have been reported at approximately 1.6% of cases, whereas complication rates range from 5.1 to 16.1% following Latarjet procedures [4, 5]. Recurrent instability following labral repair with remplissage is over 6-fold more likely than following Latarjet when glenoid bone loss exceeds 15% [6]. When addressing patients with recurrent shoulder instability, glenoid and humeral bone loss must be critically analyzed. In patients with subcritical glenoid bone loss who remain at elevated risk for recurrent instability, particularly young, high-demand athletes, arthroscopic Bankart repair with remplissage provides durable stabilization with recurrence rates comparable to Latarjet. However, in the setting of critical glenoid bone loss or true bipolar off-track pathology, the Latarjet procedure confers superior mechanical stability and significantly reduces the risk of recurrence and revision surgery.