Complications Observed Following Labral or Rotator Cuff Repair with Use of Poly-L-Lactic Acid Implants
| Autor: | Daniel D. Buss, L. Pearce McCarty, Michael Q. Freehill, M. Russell Giveans, Milton W. Datta |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Adult
Cartilage Articular Male medicine.medical_specialty Osteolysis Adolescent Polymers Polyesters Arthroplasty Rotator Cuff Injuries Arthroscopy Rotator Cuff Young Adult Postoperative Complications Tendon Injuries Suture Anchors Synovitis Absorbable Implants Biopsy medicine Humans Orthopedics and Sports Medicine Rotator cuff Lactic Acid Retrospective Studies Labrum medicine.diagnostic_test Shoulder Joint business.industry Rotator cuff injury Magnetic resonance imaging General Medicine Middle Aged medicine.disease Magnetic Resonance Imaging Surgery Treatment Outcome medicine.anatomical_structure Debridement Female Joint Diseases Shoulder Injuries business |
| Zdroj: | The Journal of Bone and Joint Surgery. 95:507-511 |
| ISSN: | 0021-9355 |
| Popis: | Background: A variety of complications associated with the use of poly-L-lactic acid (PLLA) implants, including anchor failure, osteolysis, glenohumeral synovitis, and chondrolysis, have been reported in patients in whom these implants were utilized for labral applications. We report on a large series of patients with complications observed following utilization of PLLA implants to treat either labral or rotator cuff pathology. Methods: Patients who had undergone arthroscopic debridement to address pain and loss of shoulder motion following index labral or rotator cuff repair with PLLA implants were identified retrospectively with use of our research database. A total of forty-four patients in whom macroscopic anchor debris had been observed and/or biopsy samples had been obtained during the debridement were included in the study. Synovial biopsy samples taken at the time of the arthroscopic debridement were available for thirty-eight of the forty-four patients and were analyzed by a board-certified pathologist. Magnetic resonance imaging (MRI) scans acquired after the index procedure and data from the arthroscopic debridement were available for all patients. Results: Macroscopic intra-articular anchor debris was observed in >50% of the cases. Giant cell reaction was observed in 84%; the presence of polarizing crystalline material, in 100%; papillary synovitis, in 79%; and arthroscopically documented Outerbridge grade-III or IV chondral damage, in 70%. A significant correlation (rho = 0.36, p = 0.018) was observed between the time elapsed since the index procedure and the degree of chondral damage. A recurrent rotator cuff tear that was larger than the tear documented at the index procedure was observed in all patients whose index procedure included a rotator cuff repair. Conclusions: Clinically important gross, histologic, and MRI-visualized pathology was observed in a large cohort of patients in whom PLLA implants had been utilized to repair lesions of the labrum or rotator cuff. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence. |
| Databáze: | OpenAIRE |
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