Individual risk factors for failure after arthroscopic Bankart repair within the Instability severity Index Score (ISIS) and Glenoid Track Instability Management Score (GTIMS) frameworks: A systematic review and meta-analysis

IMPORTANCE: Recurrent anterior shoulder instability after arthroscopic Bankart repair remains a relevant clinical challenge, with reported failure rates up to 30% at long-term follow-up. Several risk stratification tools, particularly the Instability Severity Index Score (ISIS) and the Glenoid Track Instability Management Score (GTIMS), have been widely adopted in clinical practice; however, the independent contribution of their individual prognostic factors has not been comprehensively evaluated using contemporary evidence. AIM: To systematically assess and quantify the associations between individual prognostic factors included within the ISIS and GTIMS frameworks and recurrence after arthroscopic Bankart repair. EVIDENCE REVIEW: A systematic search of MEDLINE, Embase, LILACS, and Epistemonikos was reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and meta-analysis of observational studies in epidemiologyguidelines. Observational analytical studies evaluating prognostic factors for failure after arthroscopic Bankart repair were included, with a specific focus on variables incorporated into the ISIS and GTIMS frameworks, which are commonly used to guide clinical decision-making. Data extraction followed Checklist for critical Appraisal and data extraction for systematic Reviews of prediction Modelling Studies - Prognostic Factors recommendations and risk of bias was assessed using the Quality in Prognostic Studies tool . Meta-analyses using Mantel-Haenszel methods were conducted, reporting pooled odds ratios (ORs) with 95% confidence intervals (CIs). FINDINGS: Twenty-nine studies involving 11,038 patients were included, with a pooled recurrence rate of 13.34% (1471 failures). Among the individual components incorporated into the ISIS and GTIMS frameworks, the factors most consistently and strongly associated with recurrence were age