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Use of two bicortical metal screws more efficacious for bone block fixation in glenoid neck
Weppe F. Arthroscopy. 2011. doi:10.1016/j.arthro.2011.03.074
Two bicortical metal screws are more effective at affixing a coracoid bone block to the anterior glenoid neck than an absorbable interference screw is at affixing a coracoid bone plug, according to this cadaver study from French researchers.
The researchers performed the Bristow conjoined tendon tenodesis technique — bioabsorbable interference screw fixation of a coracoid bone plug — on one shoulder of 10 cadavers, performing the Latarjet-Patte coracoid transfer popularized by Walch (two-screw fixation through a larger piece of the coracoid) in the opposite shoulder. The researchers then recorded the force on the conjoined tendon necessary to pull the coracoid off the anterior glenoid, as well as the mode of construct failure.
The researchers found a median ultimate failure load of 110 N in the interference screw group, with a median ultimate failure load of 202 N in the bicortical screw group. Six of the 10 failures in the interference screw group were the result of complete avulsion of the bone plug from the socket, with the other four failures being a bone plug fracture. Seven of the bone block cases failed due to vertical fracture through both screw holes, with horizontal fracture in the distal screw hole causing failure in two cases and intratendinous rupture of the conjoined tendon causing failure in one case.