Metal and plastic suture anchors for rotator cuff repair

The role of arthroscopy in the treatment of rotator cuff tears continues to evolve and expand. The arthroscope offers several advantages to open techniques. It provides clear visualization of the glenohumeral joint, smaller incisions, no deltoid detachment, less soft-tissue dissection, less pain, and more rapid rehabilitation. The past few decades have seen explosive technological advances in the availability of arthroscopic implants, as well as improvement in equipment designs that have made arthroscopy an effective and efficient treatment tool. The development of suitable arthroscopic implants has been critical to the success of arthroscopic tissue repair. These various suture anchors are often used to reattach torn tissue back to bone in the shoulder. The past decade has seen a proliferation in the designs and types of suture anchors available, and this proliferation in implant availability often presents a confusing plethora of options. Each anchor has individual characteristics that influence the appropriateness of its usage including size, shape, composition, and holding strength. In light of the prodigious and voluminous anchor options, we attempt to concisely discuss the individual characteristics and provide quantitative data for the various metal and plastic suture anchors. We divide the anchors into 5 groups based on composition and morphology consisting of metal screw anchors, nonscrew metal anchors, minianchors, plastic suture anchors, and newer anchor designs that have not yet been tested in comparative biomechanical studies.