Comparable 1-year results after arthroscopic Latarjet using screw or suture-button fixation.

PURPOSE: To compare clinical and radiological outcomes 1 year after Arthroscopic Latarjet procedure, using two different fixation techniques: screw or suture button fixation.

METHODS

This retrospective comparative cohort study included 75 patients undergoing arthroscopic Latarjet at a single institution. Patient demographic, medical history and preoperative Western Ontario Shoulder Instability Index (WOSI) were prospectively registered. One year postoperatively, patients were divided into three groups based on fixation method and surgical experience: early screw fixation (first 25 consecutive arthroscopic cases, representing the learning phase from 2015 to 2017 = 25), late screw fixation (25 subsequent cases performed after 75 cases of surgical experience, from 2020 to 2022, n = 25), and suture button fixation (first 25 cases following technique transition in March 2022, n = 25). One-year outcomes included WOSI, recurrence of instability (reluxations), complications, satisfaction, operative time and radiological evaluations of computed tomography (CT) scans for graft healing, resorption and overall radiology score. The primary outcome was change in WOSI % from baseline to 1 year, and comparison across fixation methods.

RESULTS

Mean WOSI% improved significantly from 49.7% (standard deviation [SD] 19.1) preoperatively to 77.4% (SD 19.1) at 1 year (p < 0.001), with no significant differences between fixation methods. Graft healing was more frequent in the screw groups compared to the suture button (χ² = 7.621, p = 0.022), indicating fixation method may influence graft healing. Two traumatic reluxations occurred in the suture button group; none in the screw groups. Reoperation rate was 13.3%, with no significant difference between groups. Patient satisfaction was 84% and the fixation technique did not influence WOSI% at 1 year.

CONCLUSION

Arthroscopic Latarjet with both screw and suture button fixation techniques demonstrates improved and comparable functional outcomes at 1 year. Screw fixation was associated with higher graft healing rates. Inferior healing with suture button did not result in worse clinical outcomes.

LEVEL OF EVIDENCE: Level III.