Poly-L-lactic acid tack synovitis after arthroscopic stabilization of the shoulder.
BACKGROUND
Progress has been made in the design of bioabsorbable implants, with reduced complication rates and slower degradation times.


OBJECTIVE
To report on complications related to use of poly-L-lactic acid implants after arthroscopic shoulder stabilization procedures.


METHODS
Retrospective cohort study.


METHODS
Between 1997 and 1999, 52 patients underwent arthroscopic stabilization at one institution with an average of 2.2 poly-L-lactic acid tacks. Ten patients (19%), with an average age of 30 years, developed delayed onset of symptoms at an average of 8 months after surgery, including pain in all 10 and progressive stiffness in 6. The patients underwent magnetic resonance imaging and arthroscopic evaluation and debridement.


RESULTS
Nine patients had gross implant debris. Evidence of glenohumeral synovitis was seen arthroscopically in all 10 patients. Three patients had significant full-thickness chondral damage on the humeral head. All preexisting labral lesions were healed. One year after arthroscopic debridement, loose body removal, and synovectomy, seven patients reported no or minimal pain and full return of motion. Two patients continued to have persistent pain and stiffness, and one patient reported discomfort with overhand throwing; all three had chondral lesions.


CONCLUSIONS
Patients with symptoms of delayed pain and progressive stiffness after arthroscopic stabilization with poly-L-lactic acid implants should be evaluated for synovitis and chondral injury. Arthroscopic treatment provides a significant decrease in symptoms and increased range of motion.
Freehill
Michael Q
MQ
Sports & Orthopaedic Specialists, University of Minnesota Department of Orthopaedic Surgery, Minneapolis, Minnesota, USA.
Harms
Dana J
DJ
Huber
Shane M
SM
Atlihan
Dogan
D
Buss
Daniel D
DD
D000293:Adolescent; D000328:Adult; D001182:Arthroscopy / Q000009:adverse effects*; D001672:Biocompatible Materials; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000473:pathology / Q000601:surgery*; D019344:Lactic Acid / Q000009:adverse effects*; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D011091:Polyesters; D011108:Polymers / Q000009:adverse effects*; D011183:Postoperative Complications; D019919:Prosthesis Implantation; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D012785:Shoulder Joint / Q000473:pathology / Q000601:surgery*; D013585:Synovitis / Q000209:etiology*
D001672:Biocompatible Materials; D008567:Membranes, Artificial; D011091:Polyesters; D011108:Polymers; D019344:Lactic Acid; C033616:poly(lactide)