Protruding and Dislodged Implants

Current arthroscopic shoulder techniques require soft tissue stabilization with some form of anchor use. Proper understanding of anchor function and insertion technique is paramount to appropriate placement and eventual stabilization of soft tissue structures. Different anchors have different modes of failure and associated complications; thus, it is important that arthroscopic surgeons understand these potential issues to minimize complications. Potential complications of soft tissue stabilization with anchors in the shoulder include osteolysis, synovitis, articular cartilage damage, and failure of fixation with formation of loose bodies or implant fragments as well as protruding implants. This chapter will discuss the epidemiology of these complications, review the literature as it relates to the many different forms of implants available for shoulder arthroscopy and their associated potential complications, discuss proper surgical technique for avoiding these complications, detail strategies for retrieval and/or removal of protruding or dislodged implants during shoulder arthroscopy, and provide case examples of these strategies in use.