BACKGROUND It remains unclear whether results differ between a Latarjet procedure performed after a failed arthroscopic Bankart repair and one performed as the primary operation. PURPOSE To compare the postoperative outcomes of the Latarjet procedure when performed as primary surgery and as revision for a failed arthroscopic Bankart repair. STUDY DESIGN Cohort study; Level of evidence, 3. METHODS A multicenter retrospective comparative case-cohort analysis was performed for all patients undergoing a Latarjet procedure for recurrent anterior shoulder instability. Patients were separated into 2 groups depending on if the Latarjet procedure was performed after a failed arthroscopic Bankart repair (group 1) or as the first operation (group 2). Outcome measures included recurrent instability, reoperation rates, complications, pain, Walch-Duplay scores, and Simple Shoulder Test. RESULTS A total of 308 patients were eligible for participation in the study; 72 (23.4%) did not answer and were considered lost to follow-up, leaving 236 patients available for analysis. Mean follow-up was 3.4 ± 0.8 years. There were 20 patients in group 1 and 216 in group 2. Despite similar rates of recurrent instability (5.0% in group 1 vs 2.3% in group 2; P = .5) and revision surgery (0% in group 1 vs 6.5% in group 2; P = .3), group 1 demonstrated significantly worse pain scores (2.56 ± 2.7 vs 1.2 ± 1.7; P = .01) and patient-reported outcomes (Walch-Duplay: 52 ± 25.1 vs 72.2 ± 25.0; P = .0007; Simple Shoulder Test: 9.3 ± 2.4 vs 10.7 ± 1.9; P = .001) when compared with those patients undergoing primary Latarjet procedures. CONCLUSION Functional outcome scores and postoperative pain are significantly worse in patients undergoing a Latarjet procedure after a failed arthroscopic Bankart repair when compared with patients undergoing primary Latarjet. The assumption that a failed a Bankart repair can be revised by a Latarjet with a similar result to a primary Latarjet appears to be incorrect. Surgeons should consider these findings when deciding on the optimal surgical procedure for recurrent shoulder instability.

中文翻译：

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Latarjet手术治疗慢性前肩不稳的结果：先前行关节镜检查Bankart修复的患者与主要病例。

背景技术尚不清楚在关节镜内Bankart修复失败后进行的Latarjet手术与作为主要手术的Latarjet手术之间的结果是否有所不同。目的比较Latarjet手术作为主要手术和关节镜行Bankart修复失败的翻修手术后的结果。研究设计队列研究；证据等级，3。方法对所有因复发性前肩不稳而接受Latarjet手术的患者进行了多中心回顾性比较病例队列分析。根据是否在关节镜内Bankart修复失败后进行Latarjet手术（第1组）或作为首次手术（第2组）将患者分为两组。结果指标包括反复不稳定，再次手术率，并发症，疼痛，Walch-Duplay得分和简单肩膀测试。结果共有308名患者符合研究条件。72名（23.4％）没有回答，被认为没有随访，留下236名患者可供分析。平均随访时间为3.4±0.8年。第1组中有20例患者，第2组中有216例患者。尽管复发不稳定的发生率相似（第1组为5.0％，第2组为2.3％； P = .5）和翻修手术（第1组为0％，第2组为6.5％）。第2组； P = .3），第1组的疼痛评分（2.56±2.7 vs 1.2±1.7； P = 0.01）和患者报告的结局（Walch-Duplay：52±25.1 vs 72.2±25.0； P = .0007；简单肩部测试：与接受初次Latarjet手术的患者相比，为9.3±2.4 vs 10.7±1.9； P = .001）。结论关节镜下Bankart修复失败后接受Latarjet手术的患者的功能结局评分和术后疼痛与接受原发Latarjet的患者相比明显更差。失败的Bankart维修可以通过Latarjet进行修改而得出的结果与主要Latarjet相似的假设似乎是不正确的。在决定复发性肩关节不稳定的最佳手术方法时，外科医生应考虑这些发现。