Abstract
Background:
Suture anchors for labral repair have been associated with complications including suprascapular notch encroachment and osteolysis.
Case Description:
We present a case of suture anchor penetration of the anterior glenoid neck leading to pain secondary to subscapularis muscle irritation in a 14-year-old boy. The patient had labral repair and subsequent anterior shoulder pain which resolved after anchor removal.
Literature Review:
Chondrolysis of the glenohumeral joint has been described following labral repair with knotless anchors. There have also been cases of injury to the suprascapular nerve following labral repair. However, we are not aware of any reports describing suture anchor penetration of the anterior glenoid neck leading to pain secondary to subscapularis muscle irritation.
Purposes and Clinical Relevance:
Labral repair has become a common and routine procedure, but complications can occur. We report a new complication related to osseous penetration of the anterior glenoid neck of the scapula by a suture anchor. We identified the complication using magnetic resonance imaging, an important part in reproducible, noninvasive, and objective assessment of the postoperative shoulder. We also present the technique for anchor removal used to resolve the patient’s anterior shoulder pain.
References
Athwal GS, Shridharani SM, O’Driscoll SW. Osteolysis and arthropathy of the shoulder after use of bioabsorbable knotless suture anchors. A report of four cases. J Bone Joint Surg Am. 2006;88(8):1840-1845.
Dhawan A, Ghodadra N, Karas V, Salata M, Cole B. Complications of bioabsorbable anchors in the shoulder. Am J Sports Med. 2011;40:1424.
Grutter PW, McFarland EG, Zikria BA, Dai Z, Petersen SA. Techniques for suture anchor removal in shoulder surgery. Am J Sports Med. 2010;38(8):1706-1710.
Neal SL, Fields KB. Peripheral nerve entrapment and injury in the upper extremity. Am Fam Physician. 2010;81(2):147-155.
Yoo JC, Lee YS, Ahn JH, Park JH, Kang HJ, Koh KH. Isolated suprascapular nerve injury below the spinoglenoid notch after SLAP repair. J Should Elb Surg. 2009;18:e27-e29.
Disclosures
Conflict of Interest:
Robert G. Marx, MD receives royalty payment from Demos Health and Springer, outside the work. Lana Verkuil, BA, Sean Wilson, BA and Li Foong Foo, MD have declared that they have no conflict of interest.
Human/Animal Rights:
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5).
Informed Consent:
Informed consent was waived from all patients included in the study.
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Marx, R.G., Verkuil, L., Wilson, S. et al. Anterior Glenoid Perforation with Suture Anchor Causing Subscapularis Irritation and Pain. HSS Jrnl 9, 208–211 (2013). https://doi.org/10.1007/s11420-013-9339-7
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DOI: https://doi.org/10.1007/s11420-013-9339-7