Background: Some studies have advocated the use of suture-button fixation during the Latarjet procedure to reduce complications associated with screw fixation. However, the sample size of these studies is relatively small, and their follow-up period is short.
Purpose: To investigate the efficacy of the suture-button Latarjet procedure with at least 3 years of follow-up and remodeling of the coracoid graft.
Study design: Case series; Level of evidence, 4.
Methods: A total of 152 patients who underwent the suture-button Latarjet procedure between February 2013 and February 2016 were selected, and 128 patients who met the inclusion criteria were enrolled in this study. Preoperative and postoperative clinical results were assessed. The position and healing condition of the coracoid graft and arthropathy of the glenoid and humeral head were also assessed using radiography and 3-dimensional computed tomography (CT).
Results: The mean follow-up time was 40.3 ± 5.8 months. There were 102 patients included in this study. The mean visual analog scale score for pain during motion, the American Shoulder and Elbow Surgeons score, the Rowe score, and the Walch-Duplay score were improved considerably. A total of 100 grafts achieved bone union. The overall absorption rate was 12.6% ± 4.3%. Graft absorption mostly occurred on the edge and outside the "best-fit" circle of the glenoid. A vertical position was achieved in 98 grafts (96% of all cases) immediately postoperatively, with the mean graft midline center at the 4 o'clock position. In the axial view, CT showed that 89 grafts were flush to the glenoid, whereas 2 and 11 grafts were fixed medially and laterally, respectively. In all cases, the bone graft and glenoid tended to extend toward each other to form concentric circles during the remodeling process. During follow-up observations, the height of the 11 grafts that were positioned laterally (ie, above the glenoid level) exhibited a wave-curved change. No arthropathy was observed in any patient.
Conclusion: Patient outcomes were satisfactory after the modified arthroscopic suture-button Latarjet technique. Graft absorption mostly occurred on the edge and outside the "best-fit" circle of the glenoid. The graft exhibited the phenomenon of ectatic growing when it fused with the glenoid and finally remodeled to a new concentric circle with the humeral head analogous to the original glenoid. Grafts positioned laterally did not cause arthropathy of the joints within the period of the study.
Keywords: Latarjet; anterior instability; glenoid defect; outcome; remodeling; shoulder; suture button.
Clinical Outcomes and Radiologic Assessment of a Modified Suture Button Arthroscopic Latarjet ProcedureJ Xu et al. BMC Musculoskelet Disord 20 (1), 173. PMID 30991989.The MSB arthroscopic Latarjet procedure provides excellent outcome with few complications, and no degenerative changes were observed in the follow-up. Moreover, the graft …
Arthroscopic Latarjet: Suture-Button Fixation Is a Safe and Reliable Alternative to Screw FixationP Boileau et al. Arthroscopy 35 (4), 1050-1061. PMID 30857907.Suture-button fixation is an alternative to screw fixation for the Latarjet procedure, obtaining predictable healing with excellent graft positioning, and avoiding hardwa …
All-arthroscopic, Guided Eden-Hybbinette Procedure Using Suture-Button Fixation for Revision of Failed LatarjetP Boileau et al. J Shoulder Elbow Surg 28 (11), e377-e388. PMID 31331667.Recurrence of anterior shoulder instability after a failed Latarjet procedure can be successfully treated by an all-arthroscopic Eden-Hybbinette procedure. Suture-button …
Comparative Systematic Review of Fixation Methods of the Coracoid and Conjoined Tendon in the Anterior Glenoid to Treat Anterior Shoulder InstabilityJC Garcia Jr et al. Orthop J Sports Med 7 (1), 2325967118820539. PMID 30719477. - ReviewTransferring the coracoid to the anteroinferior border of the glenoid through the subscapularis tendon is effective, regardless of the technique. When comparing the Brist …
The Outcomes and Surgical Techniques of the Latarjet ProcedureS Bhatia et al. Arthroscopy 30 (2), 227-35. PMID 24485116. - ReviewAs noted in this review, the current literature on Latarjet outcomes consists mostly of retrospective Level IV case series. Although promising outcomes with regard to a l …