Related Experiment Video
Updated: Jun 11, 2026

Knotless Independent Double-Row Repair and Biceps Augmentation for Anterosuperior Rotator Cuff Tears
Published on: January 23, 2026
All-suture anchors exhibit less perianchor fluid formation independent of healing quality compared with
Orkun Gül1, Mustafa Afsin Ayazoglu2, Alikemal Yazıcı3
1Medicalpark Yıldızlı Hospital, Trabzon, Turkey.
Background:
Perianchor fluid collection may differ according to anchor material following arthroscopic rotator cuff repair (ARCR), but its relationship with tendon healing remains unclear. This study aimed to compare perianchor fluid collection between all-suture anchors (ASAs) and polyetheretherketone (PEEK) anchors following ARCR and to evaluate its relationship with tendon healing at mid-term follow-up.
Methods:
A retrospective comparative study was performed on patients who underwent primary ARCR using either ASA or PEEK anchors. Propensity score matching was applied to balance baseline variables, including age, sex, tear size, and bone mineral density. Clinical outcomes, including visual analog scale for pain, American Shoulder and Elbow Surgeons score, and range of motion, as well as structural integrity assessed by the Sugaya classification and perianchor fluid collection graded on magnetic resonance imaging, were evaluated at a minimum follow-up of 2 years. Perianchor fluid collection was also evaluated as absent (Grade 0) or present (Grade ≥1). Correlation analysis between fluid collection and tendon integrity was performed.
Results:
After propensity score matching, 34 matched pairs (n = 68) were analyzed. Both groups showed significant improvement in visual analog scale and American Shoulder and Elbow Surgeons scores (P < .001), with no differences between groups in clinical outcomes, range of motion, or healing rates (76.5% in ASA vs. 82.4% in PEEK; P > .05). Although the overall distribution of perianchor fluid collection grades was similar (P = .106), the presence of fluid collection (Grade ≥1) was significantly higher in the PEEK group (38.2% vs. 11.8%; P = .023). A moderate positive correlation between fluid collection and Sugaya classification was observed in the PEEK group (r = 0.606, P < .001), whereas no significant correlation was found in the ASA group.
Conclusion:
ASA and PEEK anchors yielded comparable clinical outcomes and healing rates after ARCR at a minimum 2-year follow-up. Although perianchor fluid formation correlated with repair integrity in the PEEK anchor group, ASAs demonstrated lower rates of perianchor fluid formation, with no significant association observed between fluid formation and healing quality in the ASA group.