OSTEOLYSIS AND ARTHROPATHY OF THE SHOULDER AFTER USE OF BIOABSORBABLE KNOTLESS SUTURE ANCHORS A REPORT OF FOUR CASES

摘要

Recently, bioabsorbable suture anchors have been utilized for many applications in -shoulder surgery, including rotator cuff repair and capsulolabral repair1. Bioabsorbable anchors were developed to provide secure reat-tachment of avulsed soft tissues to their osseous insertions while allowing eventual implant degradation and replacement by autogenous tissue2. Although bioabsorbable materials offer some advantages, their use is not without complications. Foreign-body reactions, osteolysis, and synovitis have been described after use of biodegradable polyglycolic acid implants in the shoulder3"5. The next-generation, poly(L-lactide) polymer implants were initially described as being well tolerated without apparent complications of lysis, loosening, or synovitis167. Poly(L-lactide) was also found to degrade much more slowly than polyglycolic acid, with the time to complete degradation estimated to be more than three years in animal models8. Furthermore, poly(L-lactide) implants were thought to have better biocompatibility than polyglycolic acid implants16. In 2003, Freehill et al..' reported similar complications, consisting of glenohumeral synovitis and chondral damage, with poly(L-lactide) tacks.