Arthroscopic Subscapularis Augmentation for the Treatment of Bankart Lesions: A Narrative Review of Indications, Techniques, and Comparative Outcomes

Recurrent anterior shoulder instability from a Bankart lesion is conventionally treated with arthroscopic Bankart repair, but recurrence remains substantial in patients with glenoid bone loss (GBL), capsular deficiency, hyperlaxity, or contact-sport participation. Arthroscopic subscapularis augmentation (ASA) tenodeses the upper third of the subscapularis to the anterior glenoid alongside Bankart repair, providing an additional anterior soft-tissue restraint. This narrative review, based on a literature search updated to September 2026, summarizes the rationale, indications, techniques, postoperative management, and outcomes of ASA. Selected observational cohorts, mostly from overlapping author groups, have reported recurrence of approximately 2.7–7.0% in high-risk patients with subcritical GBL; because these figures are compared mainly with historical series, the incremental benefit of ASA over appropriately selected comparator procedures remains uncertain. In one multicenter comparison, ASA had single-digit recurrence and fewer complications than open Latarjet, whereas Latarjet procedures had the lowest recurrence. ASA combined with bone grafting is an evolving option within the range of GBL studied so far (approximately 15–30%), not an established Latarjet equivalent. The evidence is predominantly retrospective Level III–IV with short- to mid-term follow-up, and prospective comparative studies with standardized outcome definitions are needed.