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Anchors and Sutures

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Shoulder Arthroscopy

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Abstract

Arthroscopic shoulder techniques have been significantly advanced as a result of two major events: the development of suture anchors and the introduction of ultra-high-molecular-weight-polyethylene (UHMWPE) containing suture. These anchors and their sutures play key roles in current arthroscopic shoulder surgery. In general, shoulder anchors are used in two very different areas: the glenohumeral joint for labral and ligamentous attachment to the dense glenoid bone and the bursa for rotator cuff and biceps tendon attachment to the greater or lesser tuberosity.

Suture anchor designs tend to be procedure-specific with different anchor characteristics and techniques applying to each site. Some anchor designs contain multiple sutures and hold well in osteoporotic bone (rotator cuff repairs), while others contain fewer sutures and work better in denser cortical bone (glenoid repairs). Most allow sutures to slide through an anchor eyelet for independent suture tensioning and to facilitate the creation of sliding locking knots. Knotless designs accept sutures from other anchors or the adjacent tissue and eliminate the knot tying step. Occasionally, some overlap does exist between these two areas. Shoulder instability reconstruction may require glenoid anchors for an anterior capsulolabral repair combined with cuff anchors for a remplissage attachment of the infraspinatus into the Hill Sachs lesion.

This review will cover several different features common to both types of anchor environments as well as features which differentiate the suitability of one anchor type from another. These features include the material properties for anchors and sutures, various knots and their uses, currently used suture anchors, the principles of anchor placement and common failure mechanisms, and the current debate between single- and double-row cuff repair.

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Authors and Affiliations

  1. Plano Orthopedic and Sports Medicine Center, Plano, TX, USA

    F. Alan Barber & Michael S. Howard

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  1. F. Alan Barber
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  2. Michael S. Howard
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Editors and Affiliations

  1. Department of Joint and Bone Surgery, University of Brescia, Brescia, Brescia, Italy

    Giuseppe Milano

  2. Department of Orthopaedics and Traumatology, Casa di Cura Villa Valeria, Rome, Roma, Italy

    Andrea Grasso

  3. Shoulder and Upper Limb Department, St. Luke's Hospital, Bielsko-Biała, Poland

    Roman Brzóska

  4. Department of Traumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia

    Ladislav Kovačič

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© 2023 The Author(s), under exclusive license to Springer-Verlag GmbH, DE, part of Springer Nature

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Barber, F.A., Howard, M.S. (2023). Anchors and Sutures. In: Milano, G., Grasso, A., Brzóska, R., Kovačič, L. (eds) Shoulder Arthroscopy. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-66868-9_10

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  • DOI: https://doi.org/10.1007/978-3-662-66868-9_10

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-66867-2

  • Online ISBN: 978-3-662-66868-9

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