Cost-effectiveness of the arthroscopic Bankart procedure versus open Latarjet in the treatment of anterior shoulder instability

Background: The objective of this study was to evaluate the cost-effectiveness of the Latarjet procedure compared to arthroscopic Bankart repair as first-line treatment for recurrent shoulder instability in patients with ISIS greater than 3. It was hypothesized that the Latarjet procedure is more cost-effective due to its lower recurrence rate in patients who participate in high-demanding shoulder activities. Mean age was 32.42±12.11 years (15-40). Methods: Retrospective, comparative cohort study including 33 patients (33 shoulders) with anterior shoulder instability treated with arthroscopic Bankart or Latarjet repair between 2018 and 2024. Patients aged 18 to 45 years with a minimum follow-up of 1 year, impact sports activity, and ISIS score >3 were included. Postoperative constant and Rowe scores were evaluated, and procedure costs were obtained from hospital administration. Cost-effectiveness analysis was performed using the ICER index. Results: The sample population included 27 male patients (81.8%), 6 female patients (18.2%), with mean age of 24.62 (range from 18 to 45 years); a total of 33 shoulders, The study compared the costs of arthroscopic Bankart surgery ($ 25,481) and open Latarjet surgery ($19,019), showing a significant difference (p<0.001). The cost of devices was higher for Bankart procedure ($11,399 versus $2,940 p<0.01); two anchors were used in most Bankart cases, while two titanium screws were used in all Latarjet cases. Conclusions: The Latarjet procedure, although less expensive than arthroscopic Bankart surgery, shows a clinically and statistically significant improvement in postoperative constant and Rowe scores. With no significant difference in hospitalization costs and a lower rate of recurrence of instability. Both procedures are effective in improving anterior shoulder instability.