TY - JOUR
T1 - Screw Fixation for the Latarjet Procedure May Reduce Risk of Recurrent Instability but Increases Reoperation Rate Compared to Suture-Button Fixation
T2 - A Systematic Review
AU - Maguire, James A.
AU - Dhillon, Jaydeep
AU - Sarna, Neil
AU - Keeter, Carson
AU - Scillia, Anthony J.
AU - McCulloch, Patrick C.
AU - Kraeutler, Matthew J.
N1 - Funding Information:
The authors report the following potential conflicts of interest or sources of funding: A.J.S. reports personal fees from Depuy Mitek, outside the submitted work; has board membership with the American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine, and New Jersey Orthopaedic Society; and has equity or owns stock with Biomet, CONMED Corp, Johnson & Johnson Consumer, Pfizer, Smith and Nephew, and Stryker. P.C.M. reports personal fees and nonfinancial support from Arthrex and nonfinancial support from Smith & Nephew outside the submitted work. All other authors (J.A.M., J.D., N.S., M.J.K.) declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Publisher Copyright:
© 2023 Arthroscopy Association of North America
PY - 2023
Y1 - 2023
N2 - Purpose: To perform a systematic review to compare clinical outcomes, complications, and reoperation rates of patients undergoing the Latarjet procedure with screw vs suture-button fixation. Methods: A systematic review was performed by searching PubMed, the Cochrane Library, and Embase to identify clinical studies directly comparing screw vs suture-button fixation for the Latarjet procedure. The search terms used were shoulder screw suture button. Patients were evaluated based on reoperation rate, complication rate, recurrent instability, radiologic outcomes, and patient-reported outcomes. Graft and screw position were assessed via computed tomography. Results: Seven studies (1 Level II, 6 Level III) met inclusion criteria, with 845 patients undergoing the Latarjet procedure with screw fixation (screw group) and 279 patients with suture-button fixation (suture-button group). Mean patient age ranged from 21.2 to 29.6 years. Mean follow-up time ranged from 6.0 to 40.8 months. The recurrent instability rate ranged from 0% to 2.5% in the screw group and 0% to 8.3% in the suture-button group. The reoperation rate ranged from 0% to 7.7% in the screw group compared to 0% to 1.9% in the suture-button group. One study reported significantly lower visual analog scale pain scores in the suture-button group compared with the screw group (1.5 vs 1.2, P = .003). No other studies reported significant differences in any patient-reported outcomes. There was no significant difference in horizontal or vertical graft position, graft union rate, or complication rate between groups in any study. Conclusions: The Latarjet procedure with screw fixation may result in a lower risk of recurrent instability compared to suture-button fixation, although screw fixation may also have a higher reoperation rate due to hardware-related complications. Level of Evidence: Level III, systematic review of Level II to III studies.
AB - Purpose: To perform a systematic review to compare clinical outcomes, complications, and reoperation rates of patients undergoing the Latarjet procedure with screw vs suture-button fixation. Methods: A systematic review was performed by searching PubMed, the Cochrane Library, and Embase to identify clinical studies directly comparing screw vs suture-button fixation for the Latarjet procedure. The search terms used were shoulder screw suture button. Patients were evaluated based on reoperation rate, complication rate, recurrent instability, radiologic outcomes, and patient-reported outcomes. Graft and screw position were assessed via computed tomography. Results: Seven studies (1 Level II, 6 Level III) met inclusion criteria, with 845 patients undergoing the Latarjet procedure with screw fixation (screw group) and 279 patients with suture-button fixation (suture-button group). Mean patient age ranged from 21.2 to 29.6 years. Mean follow-up time ranged from 6.0 to 40.8 months. The recurrent instability rate ranged from 0% to 2.5% in the screw group and 0% to 8.3% in the suture-button group. The reoperation rate ranged from 0% to 7.7% in the screw group compared to 0% to 1.9% in the suture-button group. One study reported significantly lower visual analog scale pain scores in the suture-button group compared with the screw group (1.5 vs 1.2, P = .003). No other studies reported significant differences in any patient-reported outcomes. There was no significant difference in horizontal or vertical graft position, graft union rate, or complication rate between groups in any study. Conclusions: The Latarjet procedure with screw fixation may result in a lower risk of recurrent instability compared to suture-button fixation, although screw fixation may also have a higher reoperation rate due to hardware-related complications. Level of Evidence: Level III, systematic review of Level II to III studies.
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U2 - 10.1016/j.arthro.2023.11.020
DO - 10.1016/j.arthro.2023.11.020
M3 - Review article
C2 - 38040391
AN - SCOPUS:85180594027
SN - 0749-8063
JO - Arthroscopy - Journal of Arthroscopic and Related Surgery
JF - Arthroscopy - Journal of Arthroscopic and Related Surgery
ER -