Arthroscopic Management of Shoulder Instability: Bio-Anchor (Linvatec)

Abstract

The early development of suture anchors focused on suture fixation to bone. As the initial anchor designs were replaced by ones with greater load to failure strength, ease of insertion, and the ability to accommodate multiple sutures, screw type anchors and other nonscrew anchor designs appeared.^1–5 Concerns about the possible challenges posed by the metallic devices⁶ include infection⁷ and impaired imaging studies.⁸ The most recent innovations address the issue of potential revision surgery. How does the surgeon revise a shoulder with previously placed suture anchors? Placing additional anchors in a shoulder can be technically challenging and may compromise the clinical results if infection or cold intolerance develop. One way is to remove the previous anchor either by unscrewing a screw type anchor or by drilling out a nonmetal anchor. Another approach to the problem is provided by biodegradable anchors. An anchor that provides good initial load to failure strength, but which degrades over time, has advantages analogous to the biodegradable sutures commonly used today.