Biomechanical Analysis of Plate Fixation Compared With Various Screw Configurations for Use in the Latarjet Procedure.

BACKGROUND

The biomechanical properties of coracoid fixation with a miniplate during the Latarjet procedure have not been described.

PURPOSE

To determine the biomechanical properties of miniplate fixation for the Latarjet procedure compared with various screw fixation configurations.

STUDY DESIGN

Controlled laboratory study.

METHODS

A total of 8 groups (n = 5 specimens per group) were tested at a screw insertion angle of 0°: (1) 3.75-mm single screw, (2) 3.75-mm double screw, (3) 3.75-mm double screw with washers, (4) 3.75-mm double screw with a miniplate, (5) 4.00-mm single screw, (6) 4.00-mm double screw, (7) 4.00-mm double screw with washers, and (8) 4.00-mm double screw with a miniplate. In addition, similar to groups 1 to 3 and 5 to 7, there were 30 additional specimens (n = 5 per group) tested at a screw insertion angle of 15° (groups 9-14). To maintain specimen uniformity, rigid polyurethane foam blocks were used. Testing parameters included a preload of 214 N for 10 seconds, cyclical loading from 184 to 736 N at 1 Hz for 100 cycles, and failure loading at a rate of 15 mm/min until 10 mm of displacement or specimen failure occurred.

RESULTS

All single-screw constructs and 77% of 15° screw constructs failed before the completion of cyclical loading. Across all groups, group 8 (4.00-mm double screw with miniplate) demonstrated the highest maximum failure load (

CONCLUSION

These results indicate significantly superior failure loads with the miniplate compared with all other constructs. Across all fixation techniques and screw sizes, constructs with screws inserted at 0° performed better than constructs with screws inserted at 15°.

CLINICAL RELEVANCE

The use of a miniplate for coracoid fixation during the Latarjet procedure may provide a more durable construct for the high-demand contact athlete.

Informations de copyright

© The Author(s) 2020.

Déclaration de conflit d'intérêts

One or more of the authors has declared the following potential conflict of interest or source of funding: This study was funded by Arthrex, which produces all of the fixation devices used in this study, including the screws, washers, and plates. R.M.F. has received educational support from Arthrex, Medwest, and Smith & Nephew and consulting fees from JRF, AlloSource, and Arthrex. M.R., C.A.W., and N.F. are employees of Arthrex. A.C. has received royalties from Arthrex. G.D. is an employee of Johnson & Johnson and has received royalties from Springer and speaking fees from Wright Medical. A.A.R. has received consulting fees and royalties from Arthrex. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.