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A Systematic Review of Screw and Suture Button Glenoid Augmentation Constructs
John N Manfredi1, Samuel Schick1, Kyle D Paul2
1Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Orthopaedic Journal of Sports Medicine
|October 16, 2023
Summary
Suture buttons and screws offer similar biomechanical strength for glenoid bone augmentation in shoulder instability. Both are effective, but suture buttons may reduce screw-related complications, while plate augmentation can enhance construct stability.
Area of Science:
- Orthopedic Surgery
- Biomechanics
- Sports Medicine
Background:
- Glenohumeral dislocations frequently cause glenoid bone loss, leading to recurrent shoulder instability.
- Bony augmentation is often necessary to address significant glenoid bone defects.
- Existing biomechanical studies focus on graft fixation, but a comparative review of constructs is lacking.
Purpose of the Study:
- To systematically review and compare the biomechanics of screw and suture button fixation methods for anterior glenoid bony augmentation.
- To evaluate the efficacy of different screw configurations and augmentation techniques.
Main Methods:
- A systematic review adhering to PRISMA guidelines was performed.
- Literature search conducted across PubMed, Embase, and Google Scholar (1950-2020).
- Included studies compared biomechanical outcomes of screw versus suture button fixation for anterior glenoid bone loss.
Main Results:
- Screws and suture buttons demonstrated comparable biomechanical strength (load at failure, displacement).
- Double-screw fixation was superior to single-screw fixation; bicortical fixation outperformed unicortical.
- Augmentation with a small plate increased load at failure; screw placement parallel to the glenoid was optimal.
Conclusions:
- Suture buttons present a viable alternative to screws, potentially reducing screw-related complications.
- Plate augmentation may enhance construct strength and decrease complications by dispersing force.
- Optimal screw fixation involves parallel, bicortical placement; screw type variations had minimal impact on strength.
