Evolution of Anchor Polymer Systems Used in Arthroscopic Shoulder Surgery-A Comprehensive Review

Arthroscopic shoulder surgery has undergone significant evolution over the past decades, particularly in the materials used for suture anchors. The transition from metallic to bioabsorbable polymer anchors has revolutionized soft tissue-to-bone repair procedures, offering distinct advantages in terms of biocompatibility, imaging compatibility, and reduced complications. This comprehensive review examines the current state-of-the-art in anchor polymers used in arthroscopic shoulder surgery and their biocomposite formulations. Additionally, we explore the role of biostable polymers and emerging technologies in anchor design. The review synthesizes clinical outcomes, degradation kinetics, biocompatibility profiles, and mechanical properties of various anchor polymer systems. We also discuss the challenges associated with each material type, including osteolysis, cyst formation, premature degradation, and osseointegration. Recent advances in biocomposite anchors demonstrate promising solutions to address these limitations, offering controlled degradation rates and enhanced osteoconductivity. This review provides clinicians and researchers with a comprehensive understanding of anchor polymer technologies, their clinical applications, and future directions in arthroscopic shoulder surgery. Nevertheless, potential publication bias and heterogeneity among studies should be considered when interpreting comparative data.