This prospective case series evaluates a purpose-designed guiding system and suture button fixation (Bone-Link) for arthroscopic Latarjet in 76 patients with glenoid bone loss exceeding 20%. The study asks whether guided graft positioning improves accuracy and whether suture button fixation can achieve reliable bone union without the complications of traditional bicortical screws. CT imaging at 2 weeks and 6 months objectively assessed graft position and healing.
The traditional Latarjet procedure carries a 30% overall complication rate and 7% unplanned reoperation rate by systematic review, with symptomatic screw hardware accounting for 6.5% of cases and neurologic injury reported in up to 10% of revision cases.
This paper establishes that guided arthroscopic Latarjet with suture button fixation matches screw fixation on bone union (91% vs. ~90% with screws) while eliminating hardware complications and neurologic injuries entirely in this series.
When counseling a patient with >20% glenoid bone loss or a failed prior Bankart repair, this technique offers the stability of Latarjet with an arthroscopic approach, no symptomatic hardware risk, and return to sport in 93% of cases. One critical preoperative conversation: smoking is the only modifiable risk factor for graft nonunion identified in this cohort. Advise cessation before proceeding.
The absence of a control group and short mean follow-up (14 months) are the authors' own stated limitations — longer-term data comparing suture button to screw fixation in a randomized design are still needed.
This prospective case series evaluates a purpose-designed guiding system and suture button fixation (Bone-Link) for arthroscopic Latarjet in 76 patients with glenoid bone loss exceeding 20%. The study asks whether guided graft positioning improves accuracy and whether suture button fixation can achieve reliable bone union without the complications of traditional bicortical screws. CT imaging at 2 weeks and 6 months objectively assessed graft position and healing.
The traditional Latarjet procedure carries a 30% overall complication rate and 7% unplanned reoperation rate by systematic review, with symptomatic screw hardware accounting for 6.5% of cases and neurologic injury reported in up to 10% of revision cases.
This paper establishes that guided arthroscopic Latarjet with suture button fixation matches screw fixation on bone union (91% vs. ~90% with screws) while eliminating hardware complications and neurologic injuries entirely in this series.
When counseling a patient with >20% glenoid bone loss or a failed prior Bankart repair, this technique offers the stability of Latarjet with an arthroscopic approach, no symptomatic hardware risk, and return to sport in 93% of cases. One critical preoperative conversation: smoking is the only modifiable risk factor for graft nonunion identified in this cohort. Advise cessation before proceeding.
The absence of a control group and short mean follow-up (14 months) are the authors' own stated limitations — longer-term data comparing suture button to screw fixation in a randomized design are still needed.