Use of Absorbable Versus Nonabsorbable Anchors in the Treatment of Glenohumeral Instability

INTRODUCTION In cases of shoulder instability, the placement of anchors, with the open or arthroscopic technique, can be used to repair the types of lesions denominated Bankart [disinsertion of the labrum and ligament – mainly the inferior glenohumeral ligament of the anterior border of the glenoid (most frequent), which may be an isolated detachment of the labrum and ligament or associated with a bone fragment]. A significant improvement in instability and a decrease in recurrence have been achieved as a result of improvements in the arthroscopic technique, better selection of candidate patients for intervention, and improved quality of the implants. The characteristics of the patients that have directly contributed to a positive outcome include age, sex, number of dislocations, sports activities, presence or absence of significant Hill-Sachs lesions, and a better assessment of glenoid bone loss. In turn, the quality of the implants could influence the effectiveness of the surgery. In recent decades, many types of suture anchors have been introduced to the market and classified as absorbable/biodegradable anchors, in order to differentiate them from the metallic material that constituted the previous models. Although the metallic anchor is considered safe and promotes firm fixation to the tissue, it can generate complications such as migration and chondral damage, impair the surgical review, and limit imaging studies, as well as facilitate the incarceration of the metallic implant in the bone. In turn, bioabsorbable anchors provide fixation for a limited time and healing may occur incompletely. Few studies have prospectively compared the effectiveness of these two types of anchors in the treatment of unstable shoulder syndrome, through arthroscopic Bankart lesion repair.