Introduction:
Latarjet is a widely performed procedure for anterior shoulder instability. It can be performed open or arthroscopic and with conventional screw fixation (SF) or suture button (SB). The aim of this review is to compare the two techniques to answer the question: is there any reason to abandon the screws?

Results:
Traditional open Latarjet with SF has follow-up longer than 20 years and recurrence rate reported on 5.9% with rate of developing osteoarthritis (OA) reported on 20%, but only 1.5% of graft pseudoarthrosis. Arthroscopic Latarjet in mid-term FU resulted in no recurrence of dislocations and 93.5% return to sport rate. However, 10 of 64 (15.6%) patients had revision surgery, most common removal of prominent screw. Short-term results after arthroscopic SB proved efficiency of this type of fixation. Recurrence of instability after SB fixation was observed in 3% (4 of 136), healing rate was 95% (115 of 121 patients) and 3 of 136 patients required revision procedure, because of instability recurrence.

Conclusions:
Clinically SB demonstrated similar functional outcome and ROM when compared to SF with the potential benefit of lower rates of graft resorption and hardware related complications. However, rate of instability recurrence was higher for SB technique.