The in vivo histology of an absorbable suture anchor: a preliminary report

      This paper is only available as a PDF. To read, Please Download here.


      Suture anchors are playing an increasingly important role in attaching tendons or ligaments to bone. Anchors are usually made of metallic or other nonbioabsorbable materials. The development of an absorbable suture anchor would provide a valuable tool for the surgeon; this characteristic would minimize the problems of anchor loosening, migration, interference with imaging studies, and the potential requirement for later implant removal. This study evaluated the in vivo histological response over time of the first generation Arthrex Expanding Suture Plug (ESP) (Arthrex Inc, Naples, FL). Suture anchors threaded with nonab- sorbable No. 2 braided polyester sutures were implanted into ram femurs and removed at various intervals over a period of 12 weeks. After preparation, histological study showed a gradual healing response in the bone tract. There was no evidence of an inflammatory infiltrate or foreign-body reaction during the 12 weeks of implantation. A normal bone callus appeared at the insertion tunnel site consistent with a fracture-healing response. Later, a fibrous membrane appeared at the junction of the implant and the bone tunnel. Over the 12 week interval, there was a decrease in osteoblastic activity and the appearance of cavernous vascular spaces in the superficial portions of the membrane near the periosteum. The ESP anchor composed of poly-L-lactic acid was well tolerated in the in vivo setting. Throughout the study, no substantial acute, chronic, or foreign-body reaction was observed. These observations are consistent with the expected in vivo behavior of poly-L-lactic acid. There is no reason to believe that the ESP composed of poly-L-lactic acid should cause a foreign body reaction.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Arthroscopy
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Richmond JC
        • Donaldson WR
        • Fu F
        • Harner CD
        Modification of the Bankart reconstruction with a suture anchor report of a new technique.
        Am J Sports Med. 1991; 19: 343-346
        • Bartlett EC
        Suture Anchors for Arthroscopic Rotator Cuff Repair.
        in: Instructional Course: Arthroscopy Association of North America Annual Meeting. April 1–4, 1993
        • Zuckerman JD
        • Spivak JM
        • Richmond JC
        • et al.
        Anterior shoulder repairs using a suture to bone anchor: Description of technique and clinical results.
        in: Technical Exhibit 3716, Anaheim, CAEd 2. American Association of Orthopaedic Surgeons. March 7–11, 1991
        • Carpenter JE
        • Fish DN
        • Huston LJ
        • Goldstein SA
        Pull-out strength of five suture anchors.
        Arthroscopy. 1993; 9: 109-113
      1. Cawley PW, Howard M, Lane J, Robertson D, Zaretsky S. Comparative evaluation of bone suture anchor systems in human cadaveric shoulders: A biomechanical investigation. Am J Sports Med (in press).

        • Rozema FR
        • Bos RRM
        • Boering G
        • Leenslag JW
        • Pennings AJ
        • Verweil AB
        Absorbable bone-plates and screws for the fixation of malar fractures.
        in: Implant materials in biofunction. Ed 2. Advances in biomaterials. Vol 8. Science Publishers B.V, Elsevier, Amsterdam1988: 251-255
        • Nakamura T
        • Shimamoto T
        • Watanabe S
        • Shimizu Y
        • Hyon SH
        • Ikada Y
        Ueber die Anwendung von in vivo Zersetzbaren Polymeren in der Thoraxchirurgie.
        Makromol Chem Macromol. 1988; (Symp. 19): 201-208
        • Chabot F
        • Christel P
        • Vert M
        In vivo tests of bioresorbable bone plates in long lasting poly (L-lactic acid).
        in: UPAC Symposium. Polymers in Medicine and Biology, PragueJuly 9–12, 1987
        • Vert M
        • Christel P
        • Chabot F
        • Leray J
        Bioresorbable plastic methods for bone surgery.
        in: Hastings GW Ducheyne P Macromolecular biomaterials. 1984 (Boca Raton, FL, CRC)
        • Elrod BF
        Arthroscopic shoulder stabilization with a bioabsorbable tak.
        in: Arthroscopy Association of North America Annual Meeting. April 1–4, 1993
        • Bostman OM
        Intense granulomatous inflammatory lesions associated with absorbable internal fixation devices made of polyglycolide in ankle fractures.
        Clin Orthop. 1992; 278: 193-199
        • Bostman OM
        Osteolytic changes accompanying degradation of absorbable fracture fixation implants.
        J Bone Joint Surg Br. 1991; 73: 679-682
        • Hollinger JO
        • Battistone GC
        Biodegradable bone repair materials synthetic polymers and ceramics.
        Clin Orthop. 1986; 207: 290-305
        • Barber FA
        • Cawley P
        • Prudich JF
        Suture anchor failure strength—An in vivo study.
        Arthroscopy. 1993; 9: 647-652