Original Articles
Complications of metallic suture anchors in shoulder surgery: A report of 8 cases*

https://doi.org/10.1053/jars.2001.18246Get rights and content

Abstract

Purpose: Metallic suture anchors are widely used in open and arthroscopic operations about the shoulder. We report the cases of 8 patients who were referred to our institution with complications following shoulder surgery in which metallic suture anchors were used. Type of Study: Retrospective case series. Methods: There were 7 male patients and 1 female patient with an average age of 36 years (range, 18 to 76 years). The initial operation was open anterior reconstruction for anterior instability of the glenohumeral joint in 5 patients, open rotator cuff tear repair in 2 patients, and an open posterior capsular reconstruction for posterior instability in 1 patient. All patients were referred for evaluation after a failed index reconstructive procedure. Results: On average, 5.5 suture anchors (range, 3 to 8) per shoulder were used. Of 4 patients undergoing reconstruction with glenoid anchors only, 3 patients had an extraosseously positioned device. In this subset of glenoid-sided reconstructions, when more than 3 anchors were used, at least 1 anchor was inserted in an extraosseous position. In 2 of 3 patients with isolated humeral anchors, there was evidence of migration over time (1 intra-articular, 2 bursal). Three patients (38%) developed severe articular damage that was directly caused by a loose or intra-articular metal suture anchor. One patient developed a wound infection after reconstructive surgery. In all 8 patients, the index procedure failed and required subsequent surgery. Conclusions: The use of metallic suture anchors about the shoulder is commonplace and useful, but, as with other hardware used about the shoulder, there are significant risks if the anchors are improperly placed or if the index procedure fails.

Arthroscopy: The Journal of Arthroscopic and Related Surgery, Vol 17, No 1 (January), 2001: pp 31–37

Section snippets

Methods

This study is a retrospective review of patients referred to our institution for evaluation of a failed index reconstructive procedure about the shoulder in which suture anchors were used to repair the specific pathology. Eight patients seen over a 7-year period formed the database for this study (see Table 1).

. Patients in This Study

PatientSexAge (yr)Injury (Date)Initial DiagnosisOperation 1 (Date)Operation 2 (Date)Seen HereTime to PresentationComment
A.D.M48Fall at work (1/15/97)RCTOpen RCT

Results

On average, 5.4 suture anchors per shoulder (range, 3 to 8) were used. In the 4 patients with glenoid anchors only, 3 patients had an extraosseously positioned device. The position was either intra-articular or between the scapula and subscapularis muscle (Fig 1).

. (A) Anteroposterior shoulder radiograph showing malpositioned subscapularis glenoid suture anchor. (B) Axillary lateral radiograph showing anterior scapular position of 1 glenoid suture anchor.

When more than 3 anchors were used in

Discussion

The use of metallic suture anchors about the shoulder is commonplace, being greatly advanced by arthroscopic and open shoulder reconstructive techniques. Placing suture anchors in open Bankart repairs has been performed in an attempt to simplify the classic technique of drill holes and suture repair. Nonetheless, the need to repair the inferior glenohumeral ligament (IGHL) to the glenoid edge requires placing suture anchors near the glenoid rim and, by default, near the glenoid surface.

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*

Address correspondence and reprint requests to Robert C. Schenck, Jr., M.D., Sports Medicine Section, Univeristy of New Mexico Health Science Center, ACC-2W, Albuquerque, NM 87131-5296, U.S.A. E-mail: [email protected]

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