Traumatic shoulder instability is one of the common orthopedic diseases, and over 90% of them are anterior instability. Currently, Latarjet procedure is the most popular among various treatment methods for anterior shoulder joint instability, as it has increased the width of glenoid, solved the problem of glenoid bone defect, and prevented the dislocation of the humeral head with Hill-Sachs injury. In recent years, with the continuous advancement of arthroscopic technology, arthroscopic Latarjet procedure has been gradually introduced into clinical practice since 2006, but whether it has the same good effect as open procedure remains controversial. Objective To compare the clinical efficacy between open and arthroscopic Latarjet procedure in the treatment of anterior shoulder instability via Meta-analysis.

The search included clinical controlled trials published both at home and abroad from January 1954 to January 2018. The databases retrieved included Embase, PubMed, Central, Cinahl, PQDT, China National Knowledge Infrastructure (CNKI) , CQVIP, Wanfang Data, Cochrane Library, CBM, etc. The keywords of Chinese retrievals were Incision, Open, Arthroscopic and Latarjet. The search strategy was Latarjet AND Cut OR Arthroscopic OR Open. The keywords of English retrievals were Open, Arthroscopic and Latarjet. The search strategy was Latarjet AND Open OR Arthroscopic. After extracting the data, it was analyzed using Review Manager 5.3 software to compare the curative efficacy difference between arthroscopic and open Latarjet procedure.

According to the above retrieval strategy, a total of 887 related literatures were retrieved, and 7 foreign literatures were finally included. Through the comparison, we found when Latarjet procedure was used for treatment of anterior shoulder instability, Rowe score was better in the open group than that in the arthroscopy group [95% CI (0.03, 3.25) , P=0.05], and the fragment displacement [95% CI (0.12, 0.88) , P=0.03] and patient anxiety [95% CI (0.20, 0.75) , P=0.005] in the open group were less than that in the arthroscopy group. The difference was statistically significant. There was no difference between two groups in the remaining outcome indicators of postoperative Walch-Duplay score [95% CI (-9.57, 10.65) , P=0.92], postoperative ROM of shoulder joint [95% CI (-2.32, 7.64) , P=0.30], intraoperative and postoperative complications [95% CI (0.42, 3.39) , P=0.74]、[95% CI (0.14, 2.49) , P=0.48]、[95% CI (0.77, 14.09) , P=0.11]、[95% CI (0.46, 4.89) , P=0.51]、[95% CI (0.12, 0.88) , P=0.03]、[95% CI (0.12, 7.22) , P=0.94], postoperative recurrence rate [95% CI (0.21, 3.56) , P=0.85], postoperative VAS score [95% CI (-0.25, 2.92) , P=0.10] and operation time [95% CI (-70.10, 11.81) , P=0.10].

Open and arthroscopic Latarjet surgery for treatment of anterior shoulder instability can all achieve good effect, and the complications and recurrence are comparable. Although the open group was superior to the arthroscopic group in post-operative Rowe score, graft migration and subjective apprehension , arthroscopic surgery was still a safe and feasible treatment option.