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%,  = 0.001). There was a significantly higher rate of reoperations with S fixation compared to suture-button fixation (4.3% vs 0%,  = 0.001). There were no significant differences between the groups regarding total complications (S: 7.5% vs suture-button: 3.6%  = 0.12) graft fracture (S: 0.8% vs suture-button: 0.5%  = 0.62) and symptomatic hardware (S: 2.7% vs suture-button: 0%  = 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.