Screw Fixation Has Better Outcomes, Lower Incidence of Redislocation, and Lower Bone Resorption Than Button Fixation for Arthroscopic Anatomic Glenoid Reconstruction With Distal Tibia Allograft: A Matched Cohort Analysis
Bibliographic record
Abstract
PURPOSE: To compare the clinical outcomes between patients who received arthroscopic anatomic glenoid reconstruction (AAGR) using distal tibia allograft with button fixation versus screw fixation. METHODS: A retrospective chart review was conducted for all patients who underwent AAGR with button or screw fixation between 2012 and 2021. Patients were matched at a 1:1 ratio on the basis of sex, type of surgery, and time since surgery. All patients who were included had a minimum clinical follow-up of 2 years. Study outcomes compared Western Ontario Shoulder Instability (WOSI) Index scores, recurrence of instability, incidence of revision surgeries, and computed tomography readings. RESULTS: In total, 44 patients were included with 22 patients in each group. The preoperative glenoid bone loss was 22.57 ± 8.06% in the screw group and 22.92 ± 8.84% in the button group (P = .898). Both groups demonstrated a significant improvement in WOSI from preoperative to latest follow-up; however, patients in the screw group demonstrated significantly better WOSI scores at both 2-year (P = .003) and latest follow-up (P = .019) compared with the button group. Recurrent dislocation was observed in 9 patients (40.9%), all of whom underwent button fixation (P < .001). Two patients in the screw group experienced hardware complications (P = .488). Individuals who underwent button fixation were significantly more likely to undergo a revision surgery for recurrent instability (P = .011). Individuals in the button group demonstrated a significantly smaller mean graft anteroposterior diameter postoperatively (P < .001). CONCLUSIONS: AAGR with both screw fixation results in significantly improved WOSI scores at minimum 2-year follow-up. Button fixation has a significantly greater incidence of redislocation. Radiographic findings suggest that on average, button fixation results in greater-grade bone resorption and subsequently smaller postoperative glenoid anteroposterior width than screw fixation. LEVEL OF EVIDENCE: Level III, retrospective comparative case series.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".