However, little is known about the influence of the addition of osteoconductive materials on implant resorption, bone reaction, tendon healing, and clinical outcomes scores. Methods: Thirty-six patients were enrolled from August to January Thereby, 25 patients 84 implants were included in this retrospective study. To answer the study's questions, the following methods were applied: 1 The resorption of the implants and periimplant fluid film were assessed on MRI using a four-stage scale system, 2 bone bed diameter was measured on MRI at three different points on the longitudinal central axis of each anchor, 3 tendon integrity was evaluated on MRI according to the Sugaya classification and correlated to bone tunnel diameter, and 4 assessed tunnel diameters, periimplant fluid film grade, biodegradation grade, and tendon condition were related to clinical outcomes scores at the time of followup 2.
The intraobserver reliability was 0. This kept happening as I progressed to raising my arm on my own. My PT kept dismissing the tenderness and restriction feeling as a normal part of recovery. I didn't push back too much because I never experienced a fall or other trauma that would result in a re-tear, and I assumed there would be a lot of pain if the anchors pulled loose or if I retore the rotator cuff.
Cortisone shot didn't help. By 7 months, I was getting really strong pushups, planks, etc , and didn't think I could do those things if something was really wrong. But I still had the nagging restriction feeling in the front of my shoulder in certain situations.
Then one day, out of the blue, I had trouble lifting my arm. After that went on for a few weeks, my doc told me I would need another surgery to see what was wrong, which I had two weeks ago. Turned out the front anchor had pulled away from the bone somewhat, which put a strain on the rear anchor.
The doc did a revision repair, using 4 anchors this time. At four weeks following the first surgery, the had me lie down on the table with my arm hanging off the side. I now wonder if this was what caused the problem. Last year I re-tore my tendon. Actually I think it was more than that because when the doctor showed me pictures there was pieces of the anchor and sutures floating around. The doctor said this probably happened within a month or so of surgery.
I didn't know it at the time. I had full range of motion and no real pain until a few months later. Suddenly, at about 8 months, every time I moved my shoulder I got a loud pop and it felt like someone stuck a hot knife in there. My surgeon and my PT was so surprised I could move my shoulder or raise my arm above my head. Both of them said it couldn't be torn or I couldn't lift my arm like I did and both were so surprised to find the mess in there. So I guess what I am saying is I don't think you always know when you tear out an anchor.
I've read that MRI's are inconsistent after surgery, as apparently yours was. What I am concerned about is putting you on weights at 4 weeks. That seems really early and I wouldn't be surprised if that is what caused it. Not that you can prove anything. I am 13 weeks post op for my revision and my doctor has restricted me to NO weights until I hit 14 weeks.
Also, my doctor gave me a copy of the protocol he gave to the PT so I kind of follow along. If he would have tried weights at 4 weeks, I would have asked him to check the doctor's protocol. My advise is to be really careful. You don't want to have to do this again. And don't be afraid to question the PT. Good luck to you and I hope you recover without any incidents.
Mostly the tech was there and the PT rarely saw me. This new office I now go to the PT I am never out of sight of the PT. I'm doing pretty good Kamibri I want to be better NOW. I'm pretty sure he will say I can do some strength exercises I hope so. This surgery was a little more extensive so my PT is slow going and long. Like months long.
However I don't ever want to have any surgery of any kind again so I am following the doctor's instructions to a T. We'll all get through this somehow.. All I can say is my shoulder was worse than what we suspected. For more on suture materials click here.
Click image for a larger view So the anchor inserts to the bone and the suture attaches to the tendon - thus fixing the tendon to the bone via the suture-anchor device see below : 1. Use drill guides for accurate placement of the implant on the glenoid rim or in the tuberosity. Alternatively, the anchor should be placed in bone under direct vision, with removal of enough soft tissue to verify the anchor position. The surgeon should be aware that the anterior - inferior glenoid has the least margin of error for the placement of stabilization anchors.
Similarly, for rotator cuff repairs, the surgeon should know which areas of the humerus have the strongest and weakest bone. Some anchors and tacks perform well in hard but not soft bone.
The type of suture anchor eg, a screw-in versus a lodging-type anchor used will not compensate for inadequate surgical technique eg, an incorrectly positioned anchor The surgeon should have a backup surgical plan should the device fail or not fulfill its function to oppose the tissue to the bone.
Before beginning the procedure, the surgeon should have in place the following: A variety of implants for different applications and locations, such as devices that might provide better purchase in the glenoid or the tuberosities A plan to accommodate a loose implant or a broken insertion system A plan to retrieve the device should it migrate or be positioned incorrectly Useful Links: Compare different Suture Anchors Images courtesy of Linvatec, UK.
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