• Arch Orthop Trauma Surg · Jun 2022

    A biomechanical comparison of steel screws versus PLLA and magnesium screws for the Latarjet procedure.

    • Benjamin Bockmann, E Jaeger, L Dankl, W Nebelung, S Frey, W Schmölz, and T L Schulte.
    • Department of Orthopaedics and Trauma Surgery, St. Josef Hospital, Ruhr University Bochum, Gudrunstrasse 56, 44791, Bochum, Germany. maik-benjamin.bockmann@ruhr-uni-bochum.de.
    • Arch Orthop Trauma Surg. 2022 Jun 1; 142 (6): 1091-1098.

    IntroductionThe fixation of the coracoid process onto the glenoid is an important step of the Latarjet procedure, and implant-associated complications are a relevant and severe problem. This study compares the fixation strength and failure mode of two biodegradable materials with stainless-steel screws.Methods24 Fresh-frozen cadaveric scapulae were divided into three groups of equal size and received a coracoid transfer. Cadavers were matched according to their bone mineral density (BMD). In group 1, small-fragment screws made of stainless steel were used. In the second group, magnesium screws were used, and in the third group, screws consisted of polylactic acid (PLLA). A continuously increasing sinusoidal cyclic compression force was applied until failure occurred, which was defined as graft displacement relative to its initial position of more than 5 mm.ResultsAt 5-mm displacement, the axial force values showed a mean of 374 ± 92 N (range 219-479 N) in group 1 (steel). The force values in group 2 (magnesium) had a mean of 299 ± 57 N (range 190-357 N). In group 3 (PLLA), failure occurred at 231 ± 83 N (range 109-355 N). The difference between group 1 (steel) and group 2 (magnesium) was not statistically significant (P = 0.212), while the difference between group 1 (steel) and group 3 (PLLA) was significant (P = 0.005).ConclusionStainless-Steel screws showed the highest stability. However, all three screw types showed axial force values of more than 200 N. Stainless steel screws and PLLA screws showed screw cut-out as the most common failure mode, while magnesium screws showed screw breakage in the majority of cases.EvidenceControlled laboratory study.© 2021. The Author(s).

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