Clinical outcomes following concomitant arthroscopic rotator cuff repair and anterior shoulder stabilization: a systematic review and meta-analysis

Background: To evaluate clinical outcomes, including patient-reported function, recurrent instability, and complication rates, following concomitant arthroscopic rotator cuff repair and anterior shoulder stabilization. Methods: A systematic review was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. PubMed, Embase, and Cochrane CENTRAL were searched from inception through April 2026. Studies evaluating concomitant arthroscopic rotator cuff repair and anterior stabilization with reported post-operative outcomes were included. Pooled proportions for recurrent instability, structural rotator cuff retear, and reoperation were calculated using random-effects meta-analysis with logit transformation and Knapp–Hartung adjustment. Results: Six studies (160 patients) met inclusion criteria (Level III–IV). The pooled recurrence rate was 3.3% (95% confidence interval [CI], 1.0%-9.9%; I 2 = 0%). The pooled rotator cuff retear rate was 12.0% (95% CI, 3.4%-35.0%; I 2 = 4.1%). The pooled reoperation rate was 5.6% (95% CI, 1.2%-22.2%; I 2 = 0%). Post-operative functional scores exceeded established thresholds in cohorts with predominantly acute instability, while the sole chronic-predominant cohort fell below the Constant-Murley success threshold. Conclusion: Concomitant arthroscopic rotator cuff repair and anterior shoulder stabilization is associated with low rates of recurrent instability but a meaningful risk of structural rotator cuff failure. Outcomes appear to be influenced by instability chronicity, with acute presentations demonstrating more favorable results. Prospective studies stratified by instability chronicity and with standardized imaging surveillance are needed.