Postoperative Stiffness and Pain After Arthroscopic Labral Stabilization: Consider Anchor Arthropathy

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Abstract
Purpose: To describe the key clinical, imaging, and arthroscopic characteristics of anchor arthropathy after arthroscopic shoulder stabilization procedures and, secondarily, to define risk factors for the development of anchor‐induced arthropathy. Methods: A total of 23 patients who underwent revision arthroscopic shoulder surgery and were diagnosed with glenohumeral arthropathy were retrospectively identified from prospectively collected data registries between January 2000 and May 2018. Data included initial diagnosis and index procedure performed, presenting arthropathy symptoms including duration, and examination findings before revision surgery. Pre‐revision imaging was used to assess presence of glenohumeral osteoarthritis and chondromalacia, anchors/sutures, loose bodies, and labral pathology. The same parameters were recorded intraoperatively during revision surgery. Descriptive statistics were performed for demographic data and means with standard deviations were calculated for continuous data. A McNemar–Bowker test was used to analyze marginal homogeneity between preoperative imaging and intraoperative findings. Results: Mean age at presentation was 33.4 ± 11.7 years (range 16‐59, 17 male patients; 6 female patients). More than one half (13/23) developed symptoms within 10 months after index arthroscopic procedure (mean 32.2 ± 59.9 months, range P = .342) or glenoid ( P = .685) was not statistically significant. Conclusions: Anchor arthropathy is characterized by symptoms of pain and stiffness on examination and in many cases develops early after stabilization surgery (<10 months). Implants were implicated in the majority of cases of humeral head chondromalacia. MRI scans may produce false‐negative identification of proud implants and can be a poor predictor of the severity of chondromalacia and intra‐articular pathology; thus, a high index of clinical suspicion is necessary in patients with motion loss and pain postoperatively. Level of Evidence: Level IV, case series.
Funding Information
  • American Academy of Orthopaedic Surgeons
  • American Orthopaedic Society for Sports Medicine
  • American Shoulder and Elbow Surgeons
  • Arthrex
  • International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine
  • Siemens
  • Steadman Philippon Research Institute

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