Screw fixation versus suture-button fixation for the Latarjet procedure-a systematic review and meta-analysis

Objective: To perform a systematic review and meta-analysis to compare the results of the Latarjet procedure performed using screws (S) or suture-button for coracoid graft fixation.

Methods: A systematic search in Pubmed, EMBASE, and The Cochrane Library databases was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Cohort studies comparing outcomes in the Latarjet procedure with screw fixation versus the Latarjet procedure with suture-button fixation were included.

Results: Five studies with 877 patients were included. There was a significantly lower rate of recurrent instability in those with S fixation compared to the suture-button fixation (1.5% vs 5%, p = 0.001). There was a significantly higher rate of reoperations with S fixation compared to suture-button fixation (4.3% vs 0%, p = 0.001). There were no significant differences between the groups regarding total complications (S: 7.5% vs suture-button: 3.6% p = 0.12) graft fracture (S: 0.8% vs suture-button: 0.5% p = 0.62) and symptomatic hardware (S: 2.7% vs suture-button: 0% p = 0.12).

Conclusion: The Latarjet surgery was associated with favorable results and a low rate of complications regardless of the type of fixation used. Screw fixation was associated with a significantly lower rate of recurrences, but greater reoperations due to irritation or pain after surgery.

Level of evidence: Systematic review and meta-analysis, level III.