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We appreciate Dr. Mackie's interest in our article and concur with many of the points raised in his letter.

In our current practice we avoid metallic anchors for the same reasons he described, but we are now very cautious about using poly-L-lactic acid anchors in any athlete in whom there is a risk of uncontrolled impact.

We presently prefer plastic anchors fabricated from polyether ether ketone because we anticipate less biologic reaction in the bone. Furthermore, if necessary, polyether ether ketone anchors can be removed from bone by overdrilling.

We agree that the recent introduction of calcium phosphate composite polymers may alleviate the problem of glenoid osteolysis and deliver the goal of full bone reconstitution after resorption of the implant, but until longer-term radiologic studies in humans are available, a compromise approach seems justified.