Introduction The use of a mini-plate for coracoid fixation during the Latarjet procedure has recently been described, with encouraging radiographic outcomes. The purpose of this study was to determine the biomechanical properties of mini-plate fixation for the Latarjet procedure, and to compare these findings to various screw fixation configurations. Materials and methods Eight fixation groups ( n = 5 specimens per group) were tested at a screw insertion angle of 0° including I) 3.75 mm single-screw, II) 3.75 mm double-screw, III) 3.75 mm double-screw with washers, IV) 3.75 mm double-screw with mini-plate, V) 4.00 mm single-screw, VI) 4.00 mm double-screw, VII) 4.00 mm double-screw with washers, and VIII) 4.00 mm double-screw with mini-plate. In addition, for groups I-III and V–VII, 30 additional specimens ( n = 5 per group) were tested at a screw insertion angle of 15° (groups IX–XIV). To maintain specimen uniformity, rigid polyurethane foam blocks were used. For all specimens, testing parameters included a preload of 214 N for 10 seconds, cyclical loading from 184–736 N at 1 Hz for 100 cycles, and failure loading at a rate of 15 mm/min until 10 mm of displacement or specimen failure occurred (ElectroPuls E10000, Instron, United Kingdom). In addition, a full-field stereo-optical measurement system (ARAMIS, GOM mbH, Germany) was utilized to evaluate graft strain, graft displacement and screw displacement and rotation. Results All specimens in groups I and V (single screw constructs) and 77% of specimens within groups IX–XIV (screw insertion angle of 15°) failed prior to the completion of cyclical loading; all but one of the other specimens survived and underwent maximum load to failure testing (1 specimen in group VII failed). Across all groups, group VIII (4.00 mm; plate) demonstrated the highest maximum failure load ( P > 0.001), averaging loads 770 N higher than the next highest group ( P > 0.001). There was no significant difference in displacement during cycling between specimens with plate fixation (groups V and VIII, P > 0.05). All specimens in groups IX–XIV (insertion angle of 15°) had significant lower maximum loads to failure compared to their specimens in groups II, II, IV, VI, VII, and VIII, respectively ( P > 0.001 for all). Conclusions This is the first study to report on the biomechanical properties of the mini-plate for coracoid fixation in the Latarjet procedure. The results indicate significantly superior failure loads with the mini-plate compared to other constructs, which may have clinical implications, particularly in the high-demand contact athlete. Clinical studies with analysing patient outcomes and failure rates are necessary to determine the clinical implications of these biomechanical findings.
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