Clinics in Shoulder and Elbow

Korean Shoulder and Elbow Society (대한견·주관절의학회)
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Delayed Lateral Row Anchor Failure in Suture Bridge Rotator Cuff Repair: A Report of 3 Cases

  • Jeong, Jae-Jung (Department of Orthopedic Surgery, Daejoen St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Ji, Jong-Hun (Department of Orthopedic Surgery, Daejoen St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Park, Seok-Jae (Department of Orthopedic Surgery, Daejoen St. Mary's Hospital, College of Medicine, The Catholic University of Korea)
  • Received : 2018.09.05
  • Accepted : 2018.10.10
  • Published : 2018.12.01
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Abstract

Compared to single row repair, use of lateral row anchors in suture bridge rotator cuff repair enhances repair strength and increases footprint contact area. If a lateral knotless anchor (push-in design) is inserted into osteoporotic bone, pull-out of the lateral row anchor can developed. However, failures of lateral row anchors have been reported at several months after surgery. In our cases, even though complete cuff healing occurred, delayed pull-out of the lateral row anchor in the suture bridge repair occurred. In comparison to a conventional medial anchor, further biomechanical evaluation of the pull-out force, design, and insertion angle of the lateral anchor is needed in future studies. We report three cases with delayed pull-out of lateral row anchor in suture bridge rotator cuff repair with a literature review.

Keywords

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Fig. 3. Postoperative follow-up magnetic resonance imaging of right shoulder showed a suspected suture anchor (arrows) as a dark signal intensity in the glenohumeral joint (A), and arthroscopic examination confirmed that the anchor was in the glenohumeral joint (B).

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Fig. 1. (A, B) Immediate postoperative X-ray of right shoulder showed a good arrangement (medial 1 anchor, lateral 2 anchor) of the suture anchor in the suture bridge repair and postoperative 3-month X-ray revealed pull-out of the lateral row anchor from the greater tuberosity. (C, D) In the lateral decubitus position, revision arthroscopy using routine posterior portal was performed. Arthroscopic findings showed pull-out of the lateral anchor and complete healing of the rotator cuff; the protruding anchor was removed using the grasper.

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Fig. 2. Postoperative follow-up magnetic resonance imagings of left shoulder showed a suture anchor (arrows) as a dark signal intensity in the subacromial space (A, B) and arthroscopic removal was performed (C).

Table 1. Clinical Outcomes at Last Follow-up

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References

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