Biomechanical Analysis of Latarjet Screw Fixation: Comparison of Screw Types and Fixation Methods

Shin, Jason J.; Hamamoto, Jason T.; Leroux, Timothy; Saccomanno, Maristella F.; Jain, Anubha; Khair, M. Michael; Mellano, Christen R.; Shewman, Elizabeth; Nicholson, Gregory P.; Romeo, Anthony A.; Cole, Brian J.; Verma, Nikhil N.

doi:10.1016/j.arthro.2017.03.030

Cited by 40 publications

(47 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In this study, similar ultimate load-to-failure values in the screw and suture button fixation groups were found (226 N and 266 N, respectively). Although numerous studies have reported on the biomechanical properties of bone block fixation, 1 , 11 , 24 , 29 , 30 different testing protocols have been utilized. Our study results can only be compared with the studies that tested fixation by pulling through the conjoint tendon.…”

Section: Discussionmentioning

confidence: 99%

“…Several other studies have evaluated the biomechanical strength of various fixation techniques for the Latarjet procedure. 1 , 11 , 29 However, most of these studies assessed the effectiveness of reducing anterior shoulder instability by applying a medially directed force on the bone block, 1 , 11 , 29 which is experienced clinically by anterior translation of the humeral head in later rehabilitation phases. 1 , 11 , 24 , 29 , 32 , 33 …”

Section: Discussionmentioning

confidence: 99%

“…After preconditioning, specimens were pulled to failure at a normalized displacement rate of 400% of the measured gauge length per minute. Failure load (yield load) was classified and detected algorithmically, post hoc, via a custom script (Python 3.4; Python Software Foundation), 29 as the maximum load value that preceded a ≥5% drop-off from the local instantaneous peak load. Failure strain (%) was calculated as the displacement at failure divided by the gauge length and then multiplied by 100.…”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Biomechanical Comparison of Screw Fixation Versus a Cortical Button and Self-tensioning Suture for the Latarjet Procedure

Provencher

Aman

LaPrade

et al. 2018

Orthopaedic Journal of Sports Medicine

View full text Add to dashboard Cite

Background:Metal screws are traditionally used to fix the coracoid process to the glenoid. Despite stable fixation, metal screws have been associated with hardware complications. Therefore, some studies have advocated for suture button fixation during the Latarjet procedure to reduce the complications associated with screw fixation.Purpose:To biomechanically evaluate the ultimate failure load of a cortical button and self-tensioning suture versus metal screws for coracoid graft fixation during the Latarjet procedure.Study Design:Controlled laboratory study.Methods:Eight matched pairs of fresh-frozen, male cadaveric shoulders (N = 16) underwent the Latarjet procedure. The shoulders of each pair were randomly assigned to 1 of 2 groups: fixation using two 3.75-mm cannulated, fully threaded metal screws or fixation using a double suture button construct. Specimens were secured in a dynamic testing machine and cyclically preconditioned from 2 to 10 N at 0.1 Hz for 10 cycles. After preconditioning, specimens were pulled to failure at a normalized displacement rate of 400% of the measured gauge length per minute. The ultimate failure load and mechanism of failure were recorded for each specimen.Results:The mean ultimate load to failure for screw fixation (226 ± 114 N; 95% CI, 147-305 N) was not significantly different from that for suture button fixation (266 ± 73 N; 95% CI, 216-317 N) (P = .257). The mean strain at failure for screw fixation (63% ± 21%; 95% CI, 48%-77%) was not significantly different from that for suture button fixation (86% ± 26%; 95% CI, 69%-104%) (P = .060). The most common mechanism of failure for the screw fixation method was at the bone block drill holes, while an intramuscular rupture at the clamp-muscle interface occurred for the suture button construct.Conclusion:The screw and suture button fixation techniques exhibited comparable biomechanical strength for coracoid bone block fixation of the Latarjet procedure.Clinical Relevance:Metal screws have been reported to be a large contributor to intraoperative and postoperative complications. Therefore, given the results of the current study, a suture button construct may be an alternative to metal screw fixation during the Latarjet procedure. However, further clinical studies are warranted.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Biomechanical Comparison of Screw Fixation Versus a Cortical Button and Self-tensioning Suture for the Latarjet Procedure

Provencher

Aman

LaPrade

et al. 2018

Orthopaedic Journal of Sports Medicine

View full text Add to dashboard Cite

show abstract

“…The tests were performed pulling on the conjoined tendon in a 60° ABD and 60° external rotation and showed similar ultimate loads to failure and mean strain at failure for both double-button and screw fixation [ 27 ]. However, the mechanism of testing should be questioned, as other biomechanical studies measure the strength of the fixation by placing the testing force onto the bone block and directed medially similar to a humeral head dislocation [ 2 , 31 ]. This loading mechanism has not been yet tested for cortical button fixation.…”

Section: Discussionmentioning

confidence: 99%

Latarjet with cortical button fixation is associated with an increase of the risk of recurrent dislocation compared to screw fixation

Hardy

Sabatier²,

Schoch³

et al. 2019

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

Purpose The purpose of this study was to compare the clinical results of the Latarjet procedure using two cortical buttons vs two screws. It was hypothesized that cortical button would result in similar rates of recurrent dislocations, but a lower rate of reoperation compared to screw fixation. Methods A retrospective comparative case-cohort analysis was performed for all patients undergoing a Latarjet procedure for recurrent anterior glenohumeral instability. Patient demographics, number of dislocations prior surgery, arm dominance, shoulder hyperlaxity, level of sport, type of sport and ISIS score were collected. Shoulders were separated into two groups based on surgical fixation (screws vs cortical button). Postoperatively, shoulders were evaluated for recurrent dislocation, revision surgery, post-operative Walch-Duplay score, and the Simple shoulder test (SST). Two hundred and thirty-six patients were included in the screw fixation group (group A) and 72 in button fixation group (group B) and were evaluated at a mean follow-up of 3.4 ± 0.8 years. Demographics of the two groups were similar with the exception of operative side hand dominance, which was more common in group B [50 (69.4%) vs 128 (54.2%), p = 0.02]. Results Recurrent dislocation was significantly lower in Group A: 6 (2.5%) vs 6(8.3%) (p = 0.02). Reoperation was more common in group A [14 (5.9%) vs 0 (0%)]. At follow-up, Walch-Duplay scores and simple shoulder tests were similar in both groups. Conclusion Button fixation for Latarjet showed higher rates of recurrent dislocation compared to screw fixation. However, the increased stability afforded by screw fixation needs to be weighed against the increased risk of reoperation for hardware prominence. Level of evidence III.

show abstract

“…Whereas some evidence suggests that biomechanical performance does not depend on their type (cannulated vs cancellous and partially threaded vs fully threaded) or fixation (unicortical vs bicortical),88 another study found significant graft displacement with 3.75 mm unicortical screws compared with the same size bicortical screws, when tested in a polyurethane foam model up to 200 N 89…”

Section: Considerationmentioning

confidence: 98%

Review of Latarjet (1954) on the treatment of recurrent shoulder dislocations

Linde

Wessel

Trantalis³

et al. 2018

Journal of ISAKOS

View full text Add to dashboard Cite

Biomechanical Analysis of Latarjet Screw Fixation: Comparison of Screw Types and Fixation Methods

Cited by 40 publications

References 30 publications

Biomechanical Comparison of Screw Fixation Versus a Cortical Button and Self-tensioning Suture for the Latarjet Procedure

Biomechanical Comparison of Screw Fixation Versus a Cortical Button and Self-tensioning Suture for the Latarjet Procedure

Latarjet with cortical button fixation is associated with an increase of the risk of recurrent dislocation compared to screw fixation

Review of Latarjet (1954) on the treatment of recurrent shoulder dislocations

Contact Info

Product

Resources

About