PURPOSE The purpose of this study was to compare the clinical results of the Latarjet procedure using two cortical buttons vs two screws. It was hypothesized that cortical button would result in similar rates of recurrent dislocations, but a lower rate of reoperation compared to screw fixation. METHODS A retrospective comparative case-cohort analysis was performed for all patients undergoing a Latarjet procedure for recurrent anterior glenohumeral instability. Patient demographics, number of dislocations prior surgery, arm dominance, shoulder hyperlaxity, level of sport, type of sport and ISIS score were collected. Shoulders were separated into two groups based on surgical fixation (screws vs cortical button). Postoperatively, shoulders were evaluated for recurrent dislocation, revision surgery, post-operative Walch-Duplay score, and the Simple shoulder test (SST). Two hundred and thirty-six patients were included in the screw fixation group (group A) and 72 in button fixation group (group B) and were evaluated at a mean follow-up of 3.4 ± 0.8 years. Demographics of the two groups were similar with the exception of operative side hand dominance, which was more common in group B [50 (69.4%) vs 128 (54.2%), p = 0.02]. RESULTS Recurrent dislocation was significantly lower in Group A: 6 (2.5%) vs 6(8.3%) (p = 0.02). Reoperation was more common in group A [14 (5.9%) vs 0 (0%)]. At follow-up, Walch-Duplay scores and simple shoulder tests were similar in both groups. CONCLUSION Button fixation for Latarjet showed higher rates of recurrent dislocation compared to screw fixation. However, the increased stability afforded by screw fixation needs to be weighed against the increased risk of reoperation for hardware prominence. LEVEL OF EVIDENCE III.

中文翻译：

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与螺钉固定相比，具有皮质钮扣固定的Latarjet与复发性脱位的风险增加相关。

目的本研究的目的是比较使用两个皮质钮扣与两个螺钉的Latarjet手术的临床结果。假设皮质纽扣会导致相似的复发性脱位率，但是与螺钉固定相比，再手术率更低。方法对所有接受Latarjet手术治疗复发性前肱骨肱骨不稳的患者进行回顾性比较病例组分析。收集患者的人口统计资料，术前脱位的数量，手臂的优势，肩关节松弛，运动水平，运动类型和ISIS评分。根据手术固定（螺钉与皮质钮扣）将肩膀分为两组。术后评估肩关节是否反复脱位，翻修手术，术后Walch-Duplay评分，和简单肩膀测试（SST）。螺丝钉固定组（A组）包括263例患者，纽扣固定组（B组）包括72例患者，平均随访时间为3.4±0.8年。除手术侧手优势外，两组的人口统计学特征均相似，在B组中更为常见[50（69.4％）vs 128（54.2％），p = 0.02]。结果A组复发性脱位显着降低：6（2.5％）比6（8.3％）（p = 0.02）。再次手术在A组中更为常见[14（5.9％）vs 0（0％）]。随访时，两组的Walch-Duplay得分和简单的肩膀测验相似。结论与螺钉固定相比，Latarjet的按钮固定显示出更高的复发性脱位率。然而，需要权衡由螺钉固定提供的增加的稳定性与因硬件突出而再次操作的增加的风险。证据级别III。