Open-Guided Latarjet With Suture-Button Fixation: Early Experience

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomechanical Engineering

Background:

• Recurrent anterior shoulder instability with glenoid bone loss presents a surgical challenge.
• The traditional open Latarjet procedure with screw fixation has limitations, including hardware complications.
• Alternative fixation methods are needed to improve outcomes for shoulder instability surgery.

Purpose of the Study:

• To describe a guided open Latarjet technique utilizing dual suture-button constructs for coracoid fixation.
• To evaluate the early clinical and radiographic outcomes of this novel technique in patients with recurrent anterior shoulder instability and glenoid bone loss.

Main Methods:

• A guided open Latarjet procedure with dual suture-button fixation was performed on five male patients with recurrent anterior shoulder instability and significant glenoid bone loss.
• Patients were assessed postoperatively at 6, 12, and 24 months using the American Shoulder and Elbow Surgeons (ASES) score and visual analog scale (VAS) for pain.
• Radiographic evaluation was conducted to assess graft consolidation and positioning.

Main Results:

• Significant improvement in ASES scores from a mean of 46.5 preoperatively to 98 at 24 months.
• Marked reduction in median pain levels from 7.5 to 0 at 24 months.
• Radiographs indicated graft consolidation in 4 of 5 patients within 6 months, with no redislocations or hardware complications reported.

Conclusions:

• The guided open Latarjet technique with suture-button fixation appears technically feasible for treating shoulder instability with bone loss.
• Early clinical and radiographic findings are encouraging, suggesting potential for improved functional outcomes and reduced complications.
• Further research is warranted to confirm reproducibility and effectiveness in larger patient cohorts.