Button fixation may yield improved outcomes but has higher recurrence rate
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SAN FRANCISCO - Although both button and screw fixation improved outcomes in patients with more than 15% glenoid bone loss, results presented here showed button fixation had a higher recurrence rate.
“We’re getting poor results from this button fixation in the literature,” Ivan H. Wong, MD, FAANA, said in his presentation here. “We need to assess postoperative rehabilitation compliance, as well as what the risk factors are for this failure, before we do more with button fixation.”
Wong and colleagues compared the Western Ontario Shoulder Instability Index (WOSI), recurrent instability occurrence and incidence of revision surgery among patients with more than 15% glenoid bone loss who underwent either screw fixation or button fixation. Researchers also performed a CT scan analysis.
Patients who underwent screw fixation had better outcome scores at more than 2-year follow-up, with 100% and 56% of patients in the screw and button fixation groups, respectively, meeting the minimal clinically important difference for the WOSI, according to Wong. He added patients in the screw fixation group had no recurrence vs. a 39% recurrence rate in the button fixation group. Results showed seven patients in the button fixation group underwent revision surgery and two patients in the screw fixation group underwent hardware removal.
“When you look at those that failed button vs. those that didn’t fail button, ... you can see those that are successful with button had a normal-sized glenoid, almost 30 mm,” Wong said.
Editor’s note: The story was updated on May 20, 2022, to include more information on the patients enrolled in the study.
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Wong IH, et al. Screw fixation has better outcomes than button fixation for glenoid reconstruction: Matched analysis. Presented at: Arthroscopy Association of North America Annual Meeting. May 19-21, 2022; San Francisco.
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