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

Recurrent anterior shoulder instability associated with glenoid bone loss poses a significant surgical challenge. The open Latarjet procedure with screw fixation remains a reliable option. However, screw-related complications, such as hardware irritation and graft fracture, have prompted the exploration of alternative fixation systems. This article describes a guided open Latarjet technique using dual suture-button constructs for coracoid fixation and reports early clinical and radiographic outcomes. Five male patients (median age, 27.5 y) with recurrent anterior instability and glenoid bone loss exceeding 15% or failed previous stabilization underwent this procedure. Functional outcomes, as assessed by the American Shoulder and Elbow Surgeons (ASES) score, pain levels quantified by the visual analog scale (VAS), and graft consolidation, were evaluated at 6, 12, and 24 months postoperatively. The mean ASES score improved from 46.5 preoperatively to 98 at 24 months, while median pain levels decreased from 7.5 to 0. Serial postoperative radiographs suggested graft consolidation in 4 of 5 patients within 6 months, with acceptable graft positioning in most cases. No redislocations, subjective instability, or hardware complications occurred. In this small single-center preliminary series, the guided open Latarjet with suture-button fixation appeared technically feasible and was associated with encouraging early clinical and radiographic findings. These results should be interpreted cautiously as descriptive and exploratory rather than definitive evidence of reproducibility or effectiveness.