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Shoulder Arthritis / Rotator Cuff Tears: causes of shoulder pain: Problem with suture anchors: anchor arthropathy

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An active, motivated man in his 50s presented with pain, crepitance on motion, and stiffness of the left shoulder several years after a procedure for anterior glenohumeral instability.

His preoperative films are shown below.

To avoid the risks and limitations of a prosthetic glenoid component, he elected a ream and run procedure.

 No preoperative CT scan or 3D planning were carried out. 

The procedure was performed under general anesthesia without a brachial plexus block. At surgery, all of the suture anchors were seen to be prominent in the mid glenoid.

These were removed using a small drill and trephine, taking care to preserve glenoid bone stock.

The defects in the glenoid surface were filled with autograft from the resected humeral head. The glenoid was reamed conservatively to a smooth single concavity. 

His postoperative films are shown below.

The morning after surgery, he had excellent comfortable assisted motion.

Comment: This case shows yet another example of arthropathy from contact of the humeral head with prominent suture anchors placed on the glenoid. It was essential to remove all of the anchors prior to reaming the glenoid.

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