Arthroscopy - 2026-09-01 - Journal Article; Systematic Review; Review
High Rates of Return To Play Following Surgical Stabilization for Shoulder Instability in Adolescent Athletes: A Systematic Review.
Hodakowski AJ, Hurley ET, Villarreal-Espinosa JB, Lorentz SG, Bradley TE, Rossi L, Lau B, Dickens JF, Bradley KE
Topics
Key Takeaway
Across 1,172 adolescent athletes, the Latarjet procedure produced the lowest recurrent instability rate (0–8%) compared to arthroscopic Bankart (0–57%) and open Bankart (0–45%), though all three achieved high RTP rates.
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Summary
This systematic review evaluated RTP rates and recurrent instability after arthroscopic Bankart, open Bankart, and Latarjet procedures in adolescent athletes. Arthroscopic Bankart yielded RTP in 66–100% but recurrent instability in up to 57%; open Bankart showed RTP of 88–100% with recurrence up to 45%; Latarjet achieved RTP of 72–94% with recurrent instability of only 0–8%. All procedures produced high RTP rates, but Latarjet demonstrated superior stability with the lowest recurrence.
Key Limitation
The included studies are predominantly Level III–IV with heterogeneous definitions of RTP, recurrence, and follow-up duration, making cross-procedure comparisons descriptive rather than statistically valid.
Original Abstract
PURPOSE
To systematically review the current evidence in the literature to evaluate the rates of return to play (RTP) and subsequent recurrent instability rate after surgical stabilization of anterior shoulder instability in adolescents.
METHODS
A literature search was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies were included if they evaluated and reported on RTP after arthroscopic Bankart repair, open Bankart repair, or Latarjet procedure in adolescent athletes. The outcomes measured focused on (1) RTP, (2) RTP at the same or higher level, and (3) recurrent instability.
RESULTS
Overall, 25 studies met our inclusion criteria with 1,172 patients. Among patients undergoing arthroscopic Bankart repair, a median of 66% to 100% were able to RTP, with 56% to 100% of patients able to return to the same or higher level of competition. The overall rate of recurrent instability was 0% to 57% with a subsequent dislocation rate of 0% to 22%. Among patients undergoing open Bankart repair, a median of 88% to 100% of patients were able to RTP, and a median of 62% to 100% of patients were able to return to the same or higher level. Instability recurred in 0% to 45% of patients and 0% to 24% had a recurrent redislocation event. Among patients undergoing the Latarjet procedure, a median of 72% to 94% of patients were able to RTP and 70% to 81% were able to return to the same or higher level of play. Instability recurred in 0% to 8% of patients, and recurrent dislocation occurred in 5% to 10% of patients.
CONCLUSIONS
Adolescent patients that undergo anterior shoulder stabilization procedures RTP at high rates irrespective of the type of procedure; however, they do not return to the same level at similar rates. The Latarjet procedure results in the lowest rate of recurrent instability compared with arthroscopic or open Bankart repair.
LEVEL OF EVIDENCE
Level IV, systematic review of Level III and IV studies.