Much has changed in the world of shoulder surgery in the last few years. More operations are being done with small incisions using an arthroscope to see inside the joint. Soft tissues cut or torn can be repaired and reattached to the bone using new suture anchors and tacks. In this review article, surgeons discuss problems with such fixation devices and how to prevent them.
The authors say surgeons must be aware of possible pitfalls in the use of suture anchors or tacks. They must read the manufacturer’s directions. Knowing the anatomy can help guide the surgeon in using the right location for placement of the anchors and tacks. A backup plan is important in case the device fails.
Problems can occur such as sutures blocking the blood supply or cutting through the bone. They can break or come loose. A loose or broken anchor or tack can move inside the joint causing pain and loss of motion. Treatment depends on the problem and patient’s symptoms. The device may have to be taken out or a different type of implant used.
The authors offer surgeons many tips on what to do if the sutures break or the knots don’t slide properly. Other more serious problems such as infection, inflammation, and bone loss are discussed in detail.