Latarjet Procedure tied to Faster Return to Sports but Reduced External Rotation Compared to ICBG Transfer: Study

Significant anterior glenoid bone loss (> 15%) compromises the success of soft-tissue Bankart repair in recurrent shoulder instability. Bone-augmenting procedures—the coracoid based Latarjet and the anatomic Eden-Hybinette/iliac-crest bone-graft transfer (ICBG)—are the most frequently deployed techniques, yet direct head-to-head evidence remains limited.

Sudhir Shyam Kushwaha et al conducted a study to compare clinical and radiographic outcomes, complication profiles, and return-to-sport (RTS) rates after Latarjet versus ICBG for bony Bankart lesions.

A PRISMA-conformant search of PubMed, Embase, Scopus, and Cochrane (inception-April 2025) identified studies reporting outcomes of either procedure with ≥ 2-year follow-up. Two reviewers independently screened articles, extracted data, and graded quality (MINORS/NOS). Primary outcome was recurrent instability; secondary outcomes were complication rate, graft-related issues, osteoarthritis progression, range-of-motion (ROM) loss, patient-reported outcome measures (PROMs), and RTS.

The key findings of the study were:

• Forty-eight studies (10 comparative, 32 Latarjet-only, 6 ICBG-only) encompassing 5842 shoulders met inclusion.

• Mean follow-up was 6.2 years. Comparative meta-analysis (4 studies; n = 310) showed no significant difference in recurrent instability (OR 1.72, 95% CI 0.79–3.73; p = 0.17) or overall complications (OR 1.11, 95% CI 0.56–2.23).

• ICBG had a lower risk of graft resorption (8% vs 22%, p = 0.03) but a higher incidence of donor-site morbidity (12%).

• Latarjet provided a small but significant external-rotation loss (mean 5.7°) yet enabled faster RTS (7.8 vs 10.4 months).

• PROM improvement (ASES, WOSI, Rowe) exceeded the minimal clinically important difference for both techniques without inter-group disparities.

The authors concluded - “Both procedures reliably restore stability in the setting of bony Bankart lesions. Choice should be individualized: Latarjet offers earlier RTS and avoids extra-articular harvest morbidity, whereas ICBG preserves native coracoid anatomy and demonstrates superior graft integration. High-level prospective trials powered for clinical end-points are still required.”

Level of evidence Level III

For further details on the article refer to:

Comparative Outcomes of the Latarjet Procedure Versus Iliac Crest Bone Graft Transfer in the Management of Bony Bankart Lesion in Recurrent Anterior Shoulder Dislocations: A Systematic Review

Sudhir Shyam Kushwaha et al

Indian Journal of Orthopaedics (2026) 60:325–342

https://doi.org/10.1007/s43465-025-01602-3