Implantatkomplikationen in der Schulterarthroskopie

Abstract

With the increase in shoulder arthroscopies are increased complications related to shoulder implants frequently used for arthroscopic rotator cuff repair and shoulder stabilisation. The biggest problem is malpositioning of the suture anchor, which might lead to persistent pain, serious cartilage damage, decreased range of motion, and failure of the reconstruction, resulting in revision surgery. Especially in osteoporotic bone, it is important to choose an implant that provides sufficient mechanical strength. Other possible complications are related to the sutures of the anchor. Suture damage or accidental removal of the sutures from the anchor could leave them useless in situ. Tangling of the sutures, especially in massive reconstructions of the rotator cuff, can lead the surgeon to switch to an open technique. Compared with metal implants, bioabsorbable implants have advantages concerning possible revision surgery. However, implant costs, anchor hole enlargement, and possible higher failure rates compared with metallic implants should be considered. A rare but serious complication is allergic reaction to the implant.

Humeral head osteonecrosis following arthroscopic rotator cuff repair

“…1 Radiograph on the right shoulder, 8 months after arthroscopic cuff repair: anteroposterior and lateral view. There is an advanced loss of sphericity of the humeral head resulting from osteonecrosis related complications in shoulder surgery, Lorbach et al [8] did not find any humeral head necrosis. Glenoid osteonecrosis following arthroscopic Bankart repair with multiple anchors in body and neck of the glenoid have been reported [11].…”

“…Brislin et al [3] reported complication rate of 10.6% following arthroscopic cuff repair which included shoulder stiffness, failure of healing, infection, reflex sympathetic dystrophy, deep venous thrombosis, and death. In the study of anchors related complications in shoulder surgery, Lorbach et al [8] did not find any humeral head necrosis. Glenoid osteonecrosis following arthroscopic Bankart repair with multiple anchors in body and neck of the glenoid have been reported [11].…”

Study on the arthroscopic repair of the rotator cuff tear

“…The results proved the efficiency of arthroscopic surgery in the treatment of RCT (4-6) with low complications and a maximum of benefits in terms of pain relief and regaining motion and strength (7)(8).…”

Clinical and radiological outcome of all-suture anchors in shoulder and elbow surgery

“…[3][4][5][6] These implants are believed to be less invasive than traditional implants, and could therefore minimize anchor related complications such as secondary joint damage in case of implant loosening and migration. [7][8][9][10][11][12][13][14][15] Additionally, these implants are radiolucent, reducing artifacts in postoperative imaging. 13,14 The implantation of ASAs requires a relatively smaller bone tunnel than that of comparable classic bone anchors.…”

“…3–6 These implants are believed to be less invasive than traditional implants, and could therefore minimize anchor related complications such as secondary joint damage in case of implant loosening and migration. 7–15 Additionally, these implants are radiolucent, reducing artifacts in postoperative imaging. 13,14…”