Comparison of Arthroscopic Bankart and Remplissage With Open Latarjet in an Active-Duty Military Cohort
Bibliographic record
Abstract
Background: Subcritical bone has been shown to result in a higher rate of recurrent instability and inferior outcomes after an arthroscopic soft tissue Bankart procedure alone. The ideal surgery for patients with subcritical bone loss remains controversial, with options including arthroscopic Bankart alone, Bankart plus Remplissage (BRR), open Bankart, or a bone transfer procedure. Purpose/Hypothesis: The purpose of this study is to compare the outcomes between the arthroscopic BRR with an open Latarjet for the treatment of anterior shoulder instability in patients with glenoid bone loss (GBL) from 13.5% to 24% in an active-duty military population. It was hypothesized that there will be no difference in recurrence rate or patient-reported outcomes between the 2 procedures. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective matched-cohort comparison of patients who underwent anterior glenohumeral instability procedures with subcritical bone loss was performed. Inclusion criteria included symptomatic anterior shoulder instability, subcritical GBL (13.5% to 24%), recurrent instability with ≥2 instability episodes, surgical treatment with arthroscopic BRR or open Latarjet, and minimum follow-up of 2 years. Outcomes assessed included recurrent instability (defined as postoperative dislocation or subjective subluxation), military physical restrictions, Western Ontario Shoulder Instability Index (WOSI) score, and Single Assessment Numeric Evaluation (SANE) score. Results: In total, 50 patients were included, 25 of whom underwent an arthroscopic BRR and 25 patients who were treated with an open Latarjet. Mean bone loss was 16.1% and 19.3%, respectively. Five patients experienced recurrent instability, 3 in the arthroscopic BRR group and 2 in the open Latarjet group ( P = .64). Mean postoperative SANE score for the arthroscopic BRR group was 81.6% and open Latarjet group was 84.2% ( P = .42). Mean postoperative WOSI score for the arthroscopic BRR group was 64.6% and open Latarjet group was 67.9% ( P = .44). There was no difference in the number of patients placed on permanent military physical restriction in the arthroscopic BRR group (n = 2) compared with open Latarjet (n = 3) ( P = .64). Conclusion: In our small cohort of active-duty military patients with subcritical GBL, there was no difference in recurrent instability between arthroscopic BRR compared with open Latarjet. Additionally, there was no significant difference in postoperative SANE or WOSI scores, complications, or the number of patients placed on permanent military restriction.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".