Biomechanical Analysis of Latarjet Screw Fixation: Comparison of Screw Types and Fixation Methods

To compare the initial fixation stability, failure strength, and mode of failure of 5 different screw types and fixation methods commonly used for the classic Latarjet procedure. Thirty-five fresh-frozen cadaveric shoulder specimens were allocated into 5 groups. A 25% anteroinferior glenoid defect w...

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Veröffentlicht in:Arthroscopy 2017-09, Vol.33 (9), p.1646-1653
Hauptverfasser: Shin, Jason J., Hamamoto, Jason T., Leroux, Timothy S., Saccomanno, Maristella F., Jain, Akshay, Khair, Mahmoud M., Mellano, Christen R., Shewman, Elizabeth F., Nicholson, Gregory P., Romeo, Anthony A., Cole, Brian J., Verma, Nikhil N.
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container_end_page 1653
container_issue 9
container_start_page 1646
container_title Arthroscopy
container_volume 33
creator Shin, Jason J.
Hamamoto, Jason T.
Leroux, Timothy S.
Saccomanno, Maristella F.
Jain, Akshay
Khair, Mahmoud M.
Mellano, Christen R.
Shewman, Elizabeth F.
Nicholson, Gregory P.
Romeo, Anthony A.
Cole, Brian J.
Verma, Nikhil N.
description To compare the initial fixation stability, failure strength, and mode of failure of 5 different screw types and fixation methods commonly used for the classic Latarjet procedure. Thirty-five fresh-frozen cadaveric shoulder specimens were allocated into 5 groups. A 25% anteroinferior glenoid defect was created, and a classic Latarjet coracoid transfer procedure was performed. All grafts were fixed with 2 screws, differing by screw type and/or fixation method. The groups included partially threaded solid 4.0-mm cancellous screws with bicortical fixation, partially threaded solid 4.0-mm cancellous screws with unicortical fixation, fully threaded solid 3.5-mm cortical screws with bicortical fixation, partially threaded cannulated 4.0-mm cancellous screws with bicortical fixation, and partially threaded cannulated 4.0-mm captured screws with bicortical fixation. All screws were stainless steel. Outcomes included cyclic creep and secant stiffness during cyclic loading, as well as load and work to failure during the failure test. Intergroup comparisons were made by a 1-way analysis of variance. There were no significant differences among different screw types or fixation methods in cyclic creep or secant stiffness after cyclic loading or in load to failure or work to failure during the failure test. Post-failure radiographs showed evidence of screw bending in only 1 specimen that underwent the Latarjet procedure with partially threaded solid cancellous screws with bicortical fixation. The mode of failure for all specimens analyzed was screw cutout. In this biomechanical study, screw type and fixation method did not significantly influence biomechanical performance in a classic Latarjet procedure. When performing this procedure, surgeons may continue to select the screw type and method of fixation (unicortical or bicortical) based on preference; however, further studies are required to determine the optimal method of treatment. Surgeons may choose the screw type and fixation method based on preference when performing the Latarjet procedure.
doi_str_mv 10.1016/j.arthro.2017.03.030
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Thirty-five fresh-frozen cadaveric shoulder specimens were allocated into 5 groups. A 25% anteroinferior glenoid defect was created, and a classic Latarjet coracoid transfer procedure was performed. All grafts were fixed with 2 screws, differing by screw type and/or fixation method. The groups included partially threaded solid 4.0-mm cancellous screws with bicortical fixation, partially threaded solid 4.0-mm cancellous screws with unicortical fixation, fully threaded solid 3.5-mm cortical screws with bicortical fixation, partially threaded cannulated 4.0-mm cancellous screws with bicortical fixation, and partially threaded cannulated 4.0-mm captured screws with bicortical fixation. All screws were stainless steel. Outcomes included cyclic creep and secant stiffness during cyclic loading, as well as load and work to failure during the failure test. Intergroup comparisons were made by a 1-way analysis of variance. There were no significant differences among different screw types or fixation methods in cyclic creep or secant stiffness after cyclic loading or in load to failure or work to failure during the failure test. Post-failure radiographs showed evidence of screw bending in only 1 specimen that underwent the Latarjet procedure with partially threaded solid cancellous screws with bicortical fixation. The mode of failure for all specimens analyzed was screw cutout. In this biomechanical study, screw type and fixation method did not significantly influence biomechanical performance in a classic Latarjet procedure. When performing this procedure, surgeons may continue to select the screw type and method of fixation (unicortical or bicortical) based on preference; however, further studies are required to determine the optimal method of treatment. 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Surgeons may choose the screw type and fixation method based on preference when performing the Latarjet procedure.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>28688826</pmid><doi>10.1016/j.arthro.2017.03.030</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record>
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source MEDLINE; Access via ScienceDirect (Elsevier)
subjects Adult
Aged
Biomechanical Phenomena
Bone Screws
Cadaver
Coracoid Process - transplantation
Equipment Design
Equipment Failure
Female
Humans
Joint Instability - surgery
Male
Materials Testing - methods
Middle Aged
Osteotomy - methods
Radiography
Scapula
Shoulder Joint - surgery
title Biomechanical Analysis of Latarjet Screw Fixation: Comparison of Screw Types and Fixation Methods
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