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General Orthopaedics

The Problem With Anchors

The South African Orthopaedic Association (SAOA) 57th Annual Congress



Abstract

This is a case series of a senior surgeon's experience; the purpose being to illustrate the problems encountered when using bio-absorbable anchors for various indications in shoulder surgery.

Method.

A retrospective analysis of 7 patients' notes, radiology and arthroscopic findings between 2006 and 2010.

Results.

There were 5 females and 2 males, with an average age of 50 years 3 months. The indications for using these anchors varied; 5 patients had rotator cuff repairs, 1 had a SLAP repair and the other had a Bankart repair. Patients complained of pain (3), a noisy shoulder (2), deformity (1) and symptoms similar to an infection (1). Average time from surgery to symptoms varied, with the shortest time being 3 months and the longest being 4 years 2 months.

Some had dramatic MRI changes showing significant lysis around the anchors. Arthroscopic findings included anchor debris in the joint, loose anchors with significant defects and resultant irreversible cartilage damage.

Conclusion.

We conclude that even though these anchors are widely marketed and used in shoulder surgery, they are not without their problems, which can occur as early as three months post insertion. This has certainly changed our minds regards the use of bio-absorbable anchors in our practice.