title: Anterior Glenoid Rim Fracture Following Use of Resorbable Devices for Glenohumeral Stabilization.
abstract: BACKGROUND
  Resorbable anchors are widely used in arthroscopic stabilization of the shoulder as a means of soft tissue fixation to bone. Their function is to ensure repair stability until they are replaced by host tissue. Complications include inflammatory soft tissue reactions, cyst formation, screw fragmentation in the joint, osteolytic reactions, and enhanced glenoid rim susceptibility to fracture.
  
  
  OBJECTIVE
  To evaluate resorption of biodegradable screws and determine whether they induce formation of areas with poor bone strength that may lead to glenoid rim fracture even with minor trauma.
  
  
  METHODS
  Case series; Level of evidence, 4.
  
  
  METHODS
  This study evaluated 12 patients with anterior shoulder instability who had undergone arthroscopic stabilization with the Bankart technique and various resorbable anchors and subsequently experienced redislocation. The maximum interval between arthroscopic stabilization and the new dislocation was 52 months (mean, 22.16 months; range, 12-52 months). The mean patient age was 31.6 years (range, 17-61 years). The persistence or resorption of anchor holes; the number, area, and volume of osteolytic lesions; and glenoid erosion/fracture were assessed using computed tomography scans taken after redislocation occurred.
  
  
  RESULTS
  Complete screw resorption was never documented. Osteolytic lesions were found at all sites (mean diameter, 5.64 mm; mean depth, 8.09 mm; mean area, 0.342 cm(2); mean volume, 0.345 cm(3)), and all exceeded anchor size. Anterior glenoid rim fracture was seen in 9 patients, even without high-energy traumas (75% of all recurrences).
  
  
  CONCLUSIONS
  Arthroscopic stabilization with resorbable devices is a highly reliable procedure that is, however, not devoid of complications. In all 12 patients, none of the different implanted anchors had degraded completely, even in patients with longer follow-up, and all induced formation of osteolytic areas. Such reaction may lead to anterior glenoid rim fracture according to the literature and as found in 75% of the study patients with local osteolysis (9/12). Reducing anchor number and/or size may reduce the risk of osteolytic areas and anterior glenoid rim fracture.
authors.affiliation: UO Chirurgia della Spalla e Gomito, Ospedale Cervesi Di Cattolica, Cattolica, Italy.
authors.forename: Carlo Alberto
authors.initials: CA
authors.lastname: Augusti
authors.affiliation: UO Chirurgia della Spalla e Gomito, Ospedale Cervesi Di Cattolica, Cattolica, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Paladini
authors.affiliation: UO Chirurgia della Spalla e Gomito, Ospedale Cervesi Di Cattolica, Cattolica, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Campi
authors.affiliation: UO Chirurgia della Spalla e Gomito, Ospedale Cervesi Di Cattolica, Cattolica, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Merolla
authors.affiliation: Clinica Ortopedica, Ospedale San Gerardo dei Tintori, Monza, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Bigoni
authors.affiliation: UO Chirurgia della Spalla e Gomito, Ospedale Cervesi Di Cattolica, Cattolica, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Porcellini
keywords: devices; resorbable; shoulder; stabilization