Editorial Commentary: Can We Do Better While Spending Less: How Many Shoulder Rotator Cuff Anchors Are Enough?

Area of Science:

• Orthopedic surgery
• Biomechanical engineering
• Health economics

Background:

• Rotator cuff tear repair is a valuable procedure.
• Improving value requires cost containment without compromising outcomes.
• Reducing direct costs, such as the number of suture anchors used, is a potential strategy.

Discussion:

• Rotator cuff repair failures have both biologic and mechanical components.
• The effectiveness of increasing suture anchors to enhance outcomes is limited by biologic factors.
• Excessive use of anchors may not yield proportional improvements in repair success.

Key Insights:

• The cost-effectiveness of rotator cuff repair is established.
• Biologic healing processes play a significant role in repair success.
• There is a diminishing return on investment when increasing suture anchor usage.

Outlook:

• Future research should focus on optimizing biologic healing to improve rotator cuff repair outcomes.
• Investigating cost-effective strategies that leverage biologic potential is crucial.
• Balancing mechanical augmentation with biologic considerations is key for long-term success.