Marine Launay, Ashish Gupta, Brandon Ziegenfuss, Nicholas Green, Jashint Maharaj, Kathir Stalinm Praveen Vijaysegaran, Deniz Erbulut, Peter Pivonka, Kenneth Cutbush
The primary aim of this study is to compare the failure load of double screw (SS), double button (BB) and screw-button (SB) combined Latarjet fixation constructs under an evidence based biomechanical loading protocol. Our secondary aim is to characterise the displacement of the coracoid graft for each construct...
The Latarjet procedure stabilises the glenohumeral joint and decreases rates of re-dislocation, complications such as graft osteolysis continue to affect clinical outcomes. Superior graft osteolysis leads to prominent screw heads which may necessitate screw removal if associated with impingement pain on the subscapularis. Multiple fixation techniques have been suggested to mitigate the rate of complications seen. Double button, double screw and screw button constructs have been used. There is...
Computed tomography scans of forty matched-pair cadaveric scapulae were performed prior to harvesting. Specimens without morphological abnormalities, obvious pathologies, or prior operative intervention were harvested and dissected free of soft tissue. Individual customised 3D printed surgical jigs were designed to produce consistent 20% glenoid defects, align the coracoid graft with alpa angle of <5 degrees and to orient specimens in cementing pots. SS and BB fixation techniques were randomly...
Forty matched-pair scapulae from twenty fresh frozen cadavers with a mean age of 63.9 years (48-85) underwent testing. The mean failure load of the SB constructs was significantly higher than the BB technique (284.0N vs 135.1N, p<0.001). The mean failure load of the SB constructs vs SS technique (284.0N vs 537.8N, p<0.01), A motion tracking system found that SS, SB and BB constructs displaced on average 0.3mm, 2.3mm and 5.2mm respectively at the 100th cycle of the preloading protocol...
This cadaveric study is the first to report biomechanical data on SB constructs for graft fixation at time zero. Our findings indicate that SB may be a stronger and viable alternative to BB techniques.
Clinically, the SB technique could reduce the incidence of loading-related graft complications especially the early fixation failures because of BB construct...