JSES - 2026-06-09 - Journal Article
All-Suture Anchors Exhibit Less Perianchor Fluid Formation Independent of Healing Quality Compared With PEEK Anchors in Arthroscopic Rotator Cuff Repair: A Propensity Score-Matched Comparative Study.
Gül O, Ayazoglu MA, Yazıcı A, Durusoy S, Gürün E, Okutan AE
Topics
Key Takeaway
All-suture anchors produced perianchor fluid collection in only 11.8% of cases versus 38.2% for PEEK anchors (p=0.023), and fluid collection correlated with repair integrity only in the PEEK group (r=0.606).
Summary Depth
Choose how much analysis to show on this article page.
Summary
This study asked whether anchor material (all-suture vs. PEEK) influences perianchor fluid formation and whether that fluid correlates with tendon healing after arthroscopic rotator cuff repair. After propensity score matching for age, sex, tear size, and bone mineral density, MRI-graded perianchor fluid (Sugaya classification) and clinical outcomes were compared at minimum 2-year follow-up. Healing rates were equivalent (76.5% ASA vs. 82.4% PEEK; p>0.05), but fluid presence was significantly lower with ASA (11.8% vs. 38.2%; p=0.023), and fluid correlated with repair failure only in the PEEK group (r=0.606, p<0.001).
Key Limitation
The retrospective design with a minimum 2-year endpoint cannot determine whether the differential fluid formation rates translate into divergent retear or clinical outcome trajectories at longer follow-up, particularly for larger tears.
Original Abstract
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 (ASA) 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 (PSM) was applied to balance baseline variables, including age, sex, tear size, and bone mineral density. Clinical outcomes, including visual analog scale (VAS) for pain, American Shoulder and Elbow Surgeons (ASES) score, and range of motion (ROM), as well as structural integrity assessed by the Sugaya classification and perianchor fluid collection graded on magnetic resonance imaging (MRI), 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 PSM, 34 matched pairs (n=68) were analyzed. Both groups showed significant improvement in VAS and ASES scores (p<0.001), with no differences between groups in clinical outcomes, range of motion, or healing rates (76.5% in ASA vs. 82.4% in PEEK; p>0.05). Although the overall distribution of perianchor fluid collection grades was similar (p=0.106), the presence of fluid collection (Grade ≥1) was significantly higher in the PEEK group (38.2% vs. 11.8%; p=0.023). A moderate positive correlation between fluid collection and Sugaya classification was observed in the PEEK group (r=0.606, p<0.001), whereas no significant correlation was found in the ASA group.
CONCLUSION
ASA and PEEK anchors yielded comparable clinical outcomes and healing rates after arthroscopic rotator cuff repair at a minimum 2-year follow-up. Although perianchor fluid formation correlated with repair integrity in the PEEK anchor group, all-suture anchors demonstrated lower rates of perianchor fluid formation, with no significant association observed between fluid formation and healing quality in the ASA group.
LEVEL OF EVIDENCE
Level III, Retrospective Cohort Comparison, Treatment Study.