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      TOPIC: Sutures

      Sutures 7 years, 3 months ago #15121

      • Williams
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      Hello everyone,

      I am a 32 year old male. I injured my shoulder in the summer of 2008 and the doctor sent me for a mri arthrogram. The results showed some damage to the labrum. The doctor sent me to PT.
      After about a month, the pain began to subside, and after 3 the pain more or less disappeared. Last month, I began bench pressing lightly. My shoulder began experiencing some soreness and pain after my workouts, but disappears after a couple of days. Just as a precaution, I went back to the doctor. He said that I could elect to do surgery where he could repair the damage by placing two absorbable anchors and permanent teflon sutures. He said I can elect the surgery anytime and didn't push me to get it done. After reading through people's experience post op and through PT and the pain they have to deal with, I am hesitant to elect the surgery. I need both my arms at the job, and being in a sling for 6 weeks will not work.

      However, I do have some question about the sutures and anchor.

      Will the anchor cause any long term problems or degradation to the bone?

      How long do the sutures last?
      Will the sutures tear and cause more harm in the shoulder?
      The knots look pretty big on the Youtube videos I've seen.
      Will they interfere with my shoulder?
      Are there any long term concerns about having these sutures
      in my body?

      Thank you all in advance,

      Charles.

      Re:Sutures 7 years, 3 months ago #15125

      • ljansen
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      • 9 shoulder surgeries
      • Posts: 1358
      • Karma: 20
      Charles,

      as you noticed, the recovery from this surgery is a difficult one and one that you need to be fully invested in to recover successfully. if you don't think you are able to fit the rehab into your work schedule and it doesn't bother you all that much, i would bypass the surgery until it's something that really interferes with your daily activities, sports or work.

      in terms of your questions regarding the suture anchors,

      as long as the anchors are positioned properly (ie. inserted at the appropriate angles, not in a place that will rub against tissues/bone, etc) then the long term implications show very very few problems with the anchors. the major reasons for anchors needing to be removed later down the road is because of improper placement during surgery, but those complications are very few. the more experience the surgeon has with the shoulder, the better and the less chance of risk. the time it takes for the anchors to degrade depend on the material used, some will absorb in a few months but the majority that are used these days aren't fully absorbed for 1-2 years. most anchors are composed of poly-L-lactic acid which have shown to have very low rejection rates. there is a possibility of the suture anchors tearing or coming loose, but it takes a considerable amount of force to do that after surgery, my OS told me I would pretty well have to fall down a flight of stairs with my arm out to do that, so about the same as an initial shoulder injury. suture anchors have 3 main components, the anchor (drilled into the bone), the eyelet (attached to the anchor which is where the sutures are tied) and the sutures themselves and most problems come when the eyelet breaks off the anchor, typically that will happen before the anchor comes out of the bone. in terms of the knots on youtube, remember that those scope videos are magnifying the inside of the shoulder, they are relatively small to reduce issues with friction against tissues. again, in terms of interfering with the shoulder, the more experience the surgeon has the less the chances of interfering with shoulder function. long term concerns are very few, if anything you would show problems initially after surgery if you were rejecting it or had an infection. most of the time problems are caught before they can become severe (there may be a few on this site, but know that they are few).

      if you have any more questions feel free to ask, i've done a lot of research on the anchors and as well, any questions on the surgery or rehab feel free to ask.

      Leanne
      R. Shoulder Capsular Shift - Sept. 03
      L. Shoulder Bankart/SLAP/Capsular Shift/Rotator interval & SS repair - Jan. 05
      L. Shoulder MUA/adhesion release - Jan. 06
      L. Shoulder SAD/Bursectomy - Sept. 07
      L. Shoulder Biceps Tenodesis - Mar. 09
      L. Shoulder Open Latarjet & Arthroscopy - Nov. 24, 2011
      L. Shoulder Capsular Release/SAD - June 11, 2012
      L. Shoulder Capsular Release/Screw Removal/Biceps Tenotomy - Mar. 22, 2013
      L. Shoulder Arthroscopic Latarjet Screw Removal, Interval Repair, Axillary Neurolysis, Debridement

      Re:Sutures 7 years, 3 months ago #15126

      • sskylor
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      • Physical Therapist/Patient
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      Bench pressing will aggravate a labral tear. If you can avoid elbows below chest level and stay light you maybe able to avoid surgery, but let it heal up a little and go back to the PT exercises for awhile. This surgery is no picnic and will increse your short term disability for at least 6 months. Bioabsorbable sutures will likely remain for months, mine were still present at 10 months post-op. If your surgery is done by a highly skilled shoulder surgeon the anchors and sutures should not become a long term problem. It is all the rehab and issues like range of motion, strength return and tendonitis among other things that make this surgery a 70% success whereas rotator cuff surgeries are like 94% successful. Sharon

      Re:Sutures 7 years, 3 months ago #15129

      • Williams
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      • Posts: 3
      • Karma: 0
      Hello Leanne,

      Thank You very much for your informed reply. I appreciate your insight. My main concern is having the teflon sutures in my body
      for the rest of my life. It's never good to have foreign objects
      in your body for 30 to 40 years. I'm wondering if these things will last before tearing or causing other complications.
      Thank you again for your reply, I will definitely seek you out if I have any more questions. Right now the pain is tolerable, in fact it goes away after a few days. However, I do find the constant clicking annoying.

      Thank You,

      Charles

      Re:Sutures 7 years, 3 months ago #15131

      • Williams
      • OFFLINE
      • Fresh Boarder
      • Posts: 3
      • Karma: 0
      Hello Sharon,

      Thank You for your informative reply. The bar hits my chest when I bench press, but I do use light weights. When I talked to the doctor, he mentioned that the anchor will get absorbed by the bone, but the teflon sutures will stay in my body, as it is the only way the labrum stays intact.

      I thought he would be able to treat the tear via Prolotherapy Therapy with Platelet Rich Plasma, but unfortunately that is not the case.

      It is the rehab that concerns me. I work pretty long hours and will have a difficult time adhering to PT the the strict rehab schedule. It seems I have to follow the schedule religiously or the surgery will not be successful. I also don't want to take pain medication for a month. That stuff is poison.

      Thank you again for your reply,

      Charles

      Re:Sutures 7 years, 3 months ago #15132

      • ljansen
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      • Platinum Boarder
      • 9 shoulder surgeries
      • Posts: 1358
      • Karma: 20
      yes, the sutures will be a permanent fixture, there's just no way to hold the repair otherwise. i had my first surgery 6 years ago and when i had my last surgery in march, you could still see the suture knots from the first surgery on the shoulder. they had mostly been covered over by scar tissue and showed no signs of causing any problems around it, they looked like they were quite at home lol. if anything, i have found that more people actually have more problems with the dissolvable sutures used, mainly when suturing the inside of the incisions. 3 of my 5 surgeries they caused quite a lot of irritation and my body doesn't dissolve them, it just rejects them...so several weeks after surgery, it's quite common for me to actually have them poke through the skin and i can pull out a good couple cm's of stitch, which makes for an interesting party trick, but not a very comfortable feeling.
      R. Shoulder Capsular Shift - Sept. 03
      L. Shoulder Bankart/SLAP/Capsular Shift/Rotator interval & SS repair - Jan. 05
      L. Shoulder MUA/adhesion release - Jan. 06
      L. Shoulder SAD/Bursectomy - Sept. 07
      L. Shoulder Biceps Tenodesis - Mar. 09
      L. Shoulder Open Latarjet & Arthroscopy - Nov. 24, 2011
      L. Shoulder Capsular Release/SAD - June 11, 2012
      L. Shoulder Capsular Release/Screw Removal/Biceps Tenotomy - Mar. 22, 2013
      L. Shoulder Arthroscopic Latarjet Screw Removal, Interval Repair, Axillary Neurolysis, Debridement
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