Editorial Commentary: Button Fixation for Glenoid Bone Grafting Results in Less Graft Resorption Compared to Screws.

Abstract

Iliac crest bone grafting is conducted in cases of anteroinferior shoulder instability with substantial bone loss of the glenoid rim to reconstruct the glenoid concavity and its stabilizing function. The technique is more than 100 years old, and it evolved to include graft fixation with metal screws. The disadvantages of metal screw fixation include risk of screw migration, loosening, and breakage, as well as irritation and injury to the surrounding osseous and soft tissue structures (e.g., humeral cartilage and subscapularis muscle). With the implementation of arthroscopic techniques, new graft fixation techniques were introduced, including absorbable or biologic screws, buttons, interconnected suture anchors, and bone cerclage techniques. Recent research shows button fixation is a successful alternative to screw fixation. In addition, buttons show less graft resorption and related pain.