Complications

Treatment of internal impingement carries the same inherent risks of all arthroscopic shoulder procedures, in addition to some hazards particular to the use of thermal energy.38 The risk of partial-thickness rotator cuff tears progressing to full-thickness lesions over time certainly exists but is somewhat difficult to quantify. Complete tears are devastating, and often career-ending, injuries for elite throwers.39 Carefully assessing the percentage of the partial tear and repairing it when appropriate will help to decrease the chance of progression. Discussing the operative findings and their meaning openly with the patient will provide realistic expectations of future performance in this population.

As noted in the study from our institution, SLAP repair has the potential to decrease the overall success rate even without intervening complications.32 In addition, the anchors used to repair the lesion can become loose, break, or instigate a synovitic reaction, a problem that was specifically noted with the use of Suretac anchors.40 Positioning anchors in the proper orientation can also be difficult, leading to implants that are directed out the front or back side of the glenoid.

The complications with the use of thermal energy in the shoulder are well documented and include axillary neuropathy, capsular ablation, recurrent instability, and stiffness.17,21,41,42 Although these risks are pertinent to our discussion, much of the data collected in which the complications have occurred in the past involved the use of thermal energy to treat multidirectional instability. Transient neuritis rates have been documented as high as 8%.22 We reviewed 140 consecutive patients treated with TACS as an augmentation procedure for internal impingement or for instability alone between January 1, 1995 and December 31, 1998. In this series, just one case of transient axillary nerve neuritis (complete resolution within 6 weeks) was encountered. In addition, there were no episodes of axillary nerve injury in the 130 patients with internal impingement studied by Reinold et al.34 Postoperative stiffness and recurrent laxity are concerns that we attempt to address with our detailed and vigilant physical therapy. Complete capsular ablation has been reported17 and is more likely to occur in the face of prior techniques such as "painting" the entire capsule rather than the selective "striping" or "cornrow" technique that is used today.

Was this article helpful?

0 0
Cure Tennis Elbow Without Surgery

Cure Tennis Elbow Without Surgery

Everything you wanted to know about. How To Cure Tennis Elbow. Are you an athlete who suffers from tennis elbow? Contrary to popular opinion, most people who suffer from tennis elbow do not even play tennis. They get this condition, which is a torn tendon in the elbow, from the strain of using the same motions with the arm, repeatedly. If you have tennis elbow, you understand how the pain can disrupt your day.

Get My Free Ebook


Post a comment