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Five Cases of Misplaced Screws

Special metal sutures that look like screws are used in some types of shoulder surgery. This is a report of five cases where the screws were not placed properly. Each patient ended up with severe pain and damage to the shoulder joint.

Screws can come loose or break and move in the shoulder joint. The tip of the screw can also scrape and damage the joint when it's not buried deep enough under the bone. The patient may feel severe pain and a "clunk" or catching sensation during motion. If not corrected early, the results can be poor.

The authors of this report describe proper placement and the best angle for anchoring the screws. They use photos taken of the inside of the joint to show how to screw the anchor in and how deep to go. They advise doctors to place the tip of the lowest anchor in the five o'clock or seven o'clock position. The tip must be under the first layer of bone, not just under the cartilage.

Each of the five men in this study had a second operation. The results weren't too good. All five men were unhappy with the final results. Their severe pain continued, and their shoulders weren't stable.

These researchers suggest looking for problems after shoulder repair using metal screws. Sharp pain and a catching sensation early in rehab should be reported and examined. Treatment to revise screw placement must be done as soon as possible. These steps are needed to help prevent severe damage to the joint.

References: Yong Girl Rhee, MD, et al. Glenohumeral Arthropathy after Arthroscopic Anterior Shoulder Stabilization. In Arthroscopy. April 2004. Vol. 20. No. 4. Pp. 402-406.

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