Arthroscopic double-screw Latarjet versus arthroscopic button-fixed Latarjet with Bankart repair

The arthroscopic double-screw (DS) Latarjet procedure has been associated with low recurrence rates, a high sports return rate (SRR), and favorable clinical scores. Arthroscopic button-fixed Latarjet with Bankart repair (BB Latarjet) has been reported recently. Our hypthesis was that there were no statistically significant differences in the graft union rate, SRR, and complication rate between the arthroscopic BB Latarjet and the arthroscopic DS Latarjet, which has been considered advantageous because of its higher initial fixation strength using 2 screws.

Between 2019 and 2023, 32 patients underwent the arthroscopic BB Latarjet procedure (mean follow-up: 2.5 ± 0.5 years), and 39 patients underwent the arthroscopic DS Latarjet procedure (mean follow-up: 4.4 ± 1.4 years). Clinical outcomes, including visual analog scale scores for pain and instability, Rowe score, American Shoulder and Elbow Surgeons score, University of California, Los Angeles score,Subjective Shoulder Value, and ranges of external rotation, incidence of graft malpositioning, neurological complications, and progression of osteoarthritis, were compared between the 2 groups at the 2-year post-operative time point. Graft union rate and SRR were compared at 3-month, 6-month, 9-month, and 2-year post-operative time point.

Neither group experienced redislocation by the 2-year post-operative time point. No significant differences were observed at 2 years in visual analog scale scores for instability (P = .102) or pain (P = .50), Rowe score (P = .428), American Shoulder and Elbow Surgeons score (P = .677), or University of California, Los Angeles score (P = .433). At 3 months post-operatively, 32 cases (82.1%) achieved graft union in the DS group, whereas only 11 cases (34.4%) achieved graft union in the BB group (P < .01). However, computed tomography-based evaluation at the 2-year post-operative time point demonstrated no significant difference in graft union rate between the DS group (92.3%) and the BB group (81.3%) (P = .716). At 6 months post-operatively, the SRR in the BB group remained lower (43.8%, 14 cases), whereas the SRR in the DS group reached 76.9% (30 cases) (P = .159). Nevertheless, no significant difference in SRR was observed between the DS group (94.9%) and the BB group (93.8%) at the 2-year post-operative time point (P = .847). In contrast, the BB group exhibited fewer cases of vertical graft malpositioning (P = .049) and fewer neurological complications (P = .049).

There were no significant differences between BB Latarjet and DS Latarjet in terms of osseous union rate, SRR, recurrent instability rate, and overall complication rate at 2-year post-operative time point.