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. 2022 Feb;14(1):17-23.
doi: 10.1177/1758573220960462. Epub 2020 Sep 21.

Factors affecting biomechanical strength of Latarjet constructs: A systematic review and meta-regression

Eric G Huish Jr  1   2 , Shayne R Kelly  2 , Brenden M Cutter  2
Affiliations

Factors affecting biomechanical strength of Latarjet constructs: A systematic review and meta-regression

Eric G Huish Jr et al. Shoulder Elbow. 2022 Feb.

Abstract

Background: The Latarjet procedure reduces recurrent glenohumeral instability but has potential hardware and graft complications. The procedure has been modified to use various screw types as well as suture buttons. Biomechanical studies have evaluated the effect of these implants on construct strength. With varying results it is unclear whether there is an optimal implant to use.

Methods: We conducted a systematic review of human cadaveric biomechanical studies evaluating Latarjet ultimate failure load. Two independent reviewers screened articles and included them after full text review. Additional factors including implants used, graft orientation, cortices engaged, drill diameter, and screw characteristics were recorded. Meta-regression was performed on the 145 specimens from eight studies that met inclusion criteria.

Results: Screw fixation resulted in a 396.8 N (95% CI, 149.8-643.7) N higher ultimate failure load against shear stresses than suture buttons (p = 0.002). There were no differences between implants for ultimate failure load against tensile forces. Tensile strength was significantly affected by drill diameter with each millimeter of increase reducing the mean ultimate failure load by 127.4 N (95% CI, 41.2-213.6) N (p = 0.004).

Conclusions: These results suggest that using screw fixation and minimizing drill diameter can obtain the maximum ultimate failure load against both shear and tensile forces in a Latarjet construct.

Keywords: Latarjet; biomechanical strength; screw fixation; shoulder instability; suture button; ultimate failure load.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Flowchart of study selection.
Figure 2.
Figure 2.
Illustration of axial section through Latarjet construct utilizing screws with arrow depicting the medially directed shear force being applied.
Figure 3.
Figure 3.
Illustration of Latarjet construct utilizing screws with arrow depicting the inferiorly directed tensile force being applied through the conjoint tendon.
See this image and copyright information in PMC

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