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

Purpose: Metallic suture anchors are widely used in open and arthroscopic o perations about the shoulder. We report the cases of 8 patients who were re ferred to our institution with complications following shoulder surgery in which metallic suture anchors were used. Type of Study: Retrospect ive case series. Methods: There were 7 male patients and 1 female patient with an a verage age of 36 years (range, 18 to 76 years). The initial operation was o pen anterior reconstruction for anterior instability of the glenohumeral jo int 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 reconstructi ve procedure. Results: On average, 5.5 suture anchors (range, 3 to 8) per s houlder were used. Of 4 patients undergoing reconstruction with glenoid anc hors only, 3 patients had an extraosseously positioned device. In this subs et 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 patient s with isolated humeral anchors, there was evidence of migration over time (1 intra-articular, 2 bursal). Three patients (38%) developed severe articu lar damage that was directly caused by a loose or intra-articular metal sut ure anchor. One patient developed a wound infection after reconstructive su rgery. In all 8 patients, the index procedure failed and required subsequen t surgery, Conclusions: The use of metallic suture anchors about the should er is commonplace and useful, but, as with other hardware used about the sh oulder, there are significant risks if the anchors are improperly placed or if the index procedure fails.