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A Teleoperated Robotic System-Assisted Percutaneous Transiliac-Transsacral Screw Fixation Technique
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Screw fixation versus suture-button fixation for the Latarjet procedure-a systematic review and meta-analysis
Luciano A Rossi1, Ignacio Pasqualini2, Salvatore J Frangiamore2
1Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Shoulder & Elbow
|November 18, 2024
Summary
The Latarjet procedure using screw fixation showed fewer recurrent instability cases but more reoperations than suture-button fixation. Both methods offer favorable outcomes for shoulder instability.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Biomechanical Engineering
Background:
- Recurrent shoulder instability is a common orthopedic concern.
- The Latarjet procedure is a widely used surgical technique for treating anterior shoulder instability.
- Coracoid graft fixation is a critical step in the Latarjet procedure, with screws and suture-buttons being common methods.
Purpose of the Study:
- To systematically review and meta-analyze studies comparing screw (S) versus suture-button fixation for the coracoid graft in the Latarjet procedure.
- To evaluate the comparative efficacy and safety of these two fixation methods.
Main Methods:
- A systematic literature search was conducted in PubMed, EMBASE, and The Cochrane Library.
- Included studies were cohort studies comparing screw fixation with suture-button fixation in the Latarjet procedure.
- Data were analyzed according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines.
Main Results:
- Five studies involving 877 patients were analyzed.
- Screw fixation demonstrated a significantly lower rate of recurrent instability (1.5% vs. 5%, p=0.001).
- Screw fixation had a significantly higher rate of reoperations (4.3% vs. 0%, p=0.001) without significant differences in total complications, graft fracture, or symptomatic hardware.
Conclusions:
- The Latarjet procedure yields favorable results with low complication rates irrespective of fixation method.
- Screw fixation is associated with reduced recurrent instability but increased reoperations due to post-operative pain or irritation.
- Both screw and suture-button fixation are viable options for the Latarjet procedure, with distinct risk-benefit profiles.
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