Clinical and radiographic outcomes following open Latarjet with single button technique

This is the authors' abstract. We don't add key points for this paper.

Background: Anterior shoulder instability with significant glenoid bone loss remains a therapeutic challenge. The Latarjet procedure is effective, but screw fixation is associated with complications. Single-button fixation may provide comparable clinical and radiological outcomes with fewer complications, particularly in open approaches. Methods: A retrospective study was conducted at a level IV university hospital. Patients older than 18 years with anterior instability undergoing their first open Latarjet with single-button fixation between June 2023 and June 2024 were included. Demographic, clinical, imaging, and functional variables were assessed. Bone healing was evaluated with 3D computed tomography at 1 year, and functional outcomes were measured using the Disabilities of the Arm, Shoulder and Hand, Western Ontario Shoulder Instability Index, and visual analog scale for pain. Results: Eight patients (87.5% male; mean age 32 ± 4.7 years; follow-up 13.8 ± 1.6 months) were included. No recurrences or post-operative complications were reported. Complete bone healing occurred in 37.5%, partial in 37.5%, and absent in 25%. Final visual analog scale was 1.0 ± 0.64, Disabilities of the Arm, Shoulder and Hand 9.7 ± 6.6, and Western Ontario Shoulder Instability Index 42.4 ± 11.2. The apprehension sign resolved in all cases. Conclusion: Open Latarjet using single-button fixation with conjoint tendon augmentation demonstrated favorable clinical and functional outcomes, with no implant-related complications or clinical recurrences at a minimum 1-year follow-up. Although the rate of complete bone healing was lower compared to arthroscopic techniques with double-button fixation and double screws, this simplified approach appears to be safe and reproducible, reducing technical complexity, costs, and potential neurovascular risks.