Korean J Sports Med.  2025 Mar;43(1):41-45. 10.5763/kjsm.2025.43.1.41.

Can It be Said that this Case Confirmed the Phenomenon of Subacromial Suture Knot Impingement after Arthroscopic Rotator Cuff Repair?: A Case Report

• Kim SH
• Choi SW
• Park SH
• Park YB

• KMID: 2565716
• DOI: http://doi.org/10.5763/kjsm.2025.43.1.41

Abstract

Rotator cuff tears are common shoulder injuries, particularly in older adults. Arthroscopic rotator cuff repair (ARCR) is the preferred treatment due to its successful outcomes, but complications like suture knot impingement may arise. Knot impingement, although rare, can lead to subacromial bone erosion and persistent pain. The condition remains under-reported, and direct evidence linking knot impingement to subacromial erosion is scarce. A 63-year-old woman presented with progressively worsening shoulder pain and restricted range of motion, 10 years after undergoing ARCR. Clinical assessment indicated subacromial impingement with positive Neer, Hawkins test results and reduced shoulder mobility. Arthroscopic evaluation revealed suture knots embedded in the subacromial bone, directly causing erosion. This is the first case to confirm through arthroscopy that subacromial bone erosion resulted from knot impingement. This case emphasizes the importance of follow-up and highlights the need to consider alternative suture techniques to avoid complications like knot impingement. Surgeons should be vigilant in minimizing risks associated with suture materials and techniques to improve long-term outcomes for patients undergoing ARCR.

Keyword

Knot impingement; Subacromial erosion; Arthroscopic rotator cuff repair; Shoulder