title: Complications of metallic suture anchors in shoulder surgery: A report of 8 cases.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
authors.affiliation: Department of Orthopaedics, The University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA.
authors.forename: T K
authors.initials: TK
authors.lastname: Kaar
authors.forename: R C
authors.initials: RC
authors.lastname: Schenck
authors.forename: M A
authors.initials: MA
authors.lastname: Wirth
authors.forename: C A
authors.initials: CA
authors.lastname: Rockwood
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008670:Metals; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D013536:Suture Techniques / Q000009:adverse effects*; D017211:Treatment Failure; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging / Q000601:surgery*
chemical_list: D008670:Metals