Biomechanical Strength of Screw Versus Suture Button Fixation in the Latarjet Procedure: A Cadaver Study
Yasin Hakverdiyev, Edward G. McFarland, Mehmet Kaymakoğlu, Erdi Özdemir, Sercan Akpınar, Pınar Yılgör Huri, John G. Costouros, Gazi Huri
Abstract
We compared the strength of screw vs suture button fixation in the Latarjet procedure for shoulder dislocation through biomechanical testing in a cadaver model. Cadavers were assigned randomly to receive screw or suture button fixation (both groups, n=5). The anteroposterior radius of the glenoid was measured, and a bony defect was created on the anteroinferior rim of the glenoid, equal to 25% of the width of the anteroposterior radius of the glenoid surface. The coracoid process was transferred into the newly created bony defect of the glenoid and fixed with two 3.5-mm partially threaded cannulated screws or 2 surgical buttons. All samples underwent tensile testing in the anteroinferior direction. Statistical analysis was performed to compare mean forces at failure between groups (alpha=.05). The mean force at failure was higher in the screw group (295 N; range, 103–534 N) than in the suture button group (133 N; range, 74–270 N) ( P =.045). We found no difference between groups in ability to withstand a force of 150 N, which is the reported mean daily force threshold borne by the shoulder ( P =.52). Screw fixation withstood a higher failure load than suture button fixation, indicating that screw fixation is a biomechanically superior option in the Latarjet procedure. The fixation methods did not differ in their ability to withstand the mean force borne by the shoulder during activities of daily living; thus, suture button fixation should be considered as an option in the Latarjet procedure. [ Orthopedics . 2022;45(6):e321–e325.]