Index Radial Collateral Ligament Repair with Titanium Mini-Suture Anchor: Osteolysis Complication of an Underreported Injury

Abstract

We are reporting on a case of an index radial collateral ligament tear repaired with a titanium Mitek bone suture anchor. The development of cystic radiographic changes and increased pain and weakness led to suture anchor removal at 10 months post-repair. Periprosthetic osteolysis due to titanium-induced osteoclastogenesis and micromotion was suspected to be the cause. This case report provides a dual focus by stressing the importance of the diagnosis and treatment of this underreported ligament tear and highlighting our osteolysis complication via the mechanism of titanium-induced osteoclastogenesis for future therapeutic preventive measures.

Comparison of In Vitro Motion and Stability Between Techniques for Index Metacarpophalangeal Joint Radial Collateral Ligament Reconstruction

“…In addition to the cost of the implants, another drawback to using the interference screw is the risk of foreign body reaction such as osteolysis, which has been previously described with suture anchors used in hand surgery. (5,20) Nonetheless, these biomechanical results substantiate our clinical experience that the interference screw technique provides an optimal combination of stability and flexion at the index MP joint.…”

A Retrospective Multicenter Study of the Artelon® Carpometacarpal Joint Implant

“…However, the presence of foreign body giant cells and granulomas found about these devices has led some to the belief that the affected patients' bodies are “rejecting” these implants. Recent case reports associating Artelon® spacers with similar foreign body reactions have implied that some patients were “rejecting” the Artelon® material [4, 6, 15, 17, 21, 26]. Careful review of each of these reports reveals other possible explanations for the “foreign body reactions seen” other than the body rejecting the implant, such as complete decortication of the first metacarpal leading to possible screw loosening, possible screw penetration into the joint, use of resorbable bone anchors, use of titanium screws for fixation and placement of the Artelon® CMC Spacer into the STT joint—an “off label” use.…”

Dorsal Metacarpal Artery Perforator Flap for Skin Ulcer Due to a Postoperative Complication of Suture Anchor Treatment for Tendinous Mallet Finger

“…7 Complications related to suture anchors have been reported: anchor migration, anchor dislodgment, synovitis caused by absorbable material, osteolysis, and skin ulcer caused by foreign body reaction to the anchor. [3][4][5] In our case, we suspected a multistep mechanism of pathology: First, the tendinous mallet finger was treated by a suture anchor; second, the string of suture anchor protruded from the dorsal skin at the DIP joint and was removed; third, after removal of the string, the terminal tendon accompanying the suture knot migrated proximally; and fourth, the remaining suture knot caused the formation of a stitch abscess and skin ulcer. It was a specific point that the skin ulcer was at a site different from the original operative site.…”

“…Complications related to suture anchors have been reported, but, to our best knowledge, skin ulcer formation apart from the surgical site has not been reported in relation to the use of an anchor. [3][4][5] We report the case of a skin ulcer that developed at the dorsal middle phalanx of a finger that had been surgically treated 2 years before for tendinous mallet finger with suture anchors. The skin reconstruction entailed the use of the dorsal metacarpal artery in a perforator flap.…”