Visscher et al. trace the full developmental history of suture anchors from the 1985 Statak patent to all-suture designs, using the 'suture anchor chain' framework — anchor-bone, anchor-suture interface, suture, suture-tissue — to explain why each generation of anchors was redesigned and what biomechanical failure mode drove the change.
When selecting a suture anchor, match the anchor to the chain: anchor-bone strength must exceed suture strength, which must exceed tissue strength — if any link is undersized for the application (e.g., a mini anchor in high-load rotator cuff repair), the construct fails predictably.
When using anchors arthroscopically or at oblique angles, eyelet geometry matters: out-of-plane suture exit can reduce effective suture strength by nearly three-quarters, which is why smooth, non-channeled eyelets and knotless designs have displaced early sharp-eyelet anchors in high-demand repairs.
Visscher et al. trace the full developmental history of suture anchors from the 1985 Statak patent to all-suture designs, using the 'suture anchor chain' framework — anchor-bone, anchor-suture interface, suture, suture-tissue — to explain why each generation of anchors was redesigned and what biomechanical failure mode drove the change.
When selecting a suture anchor, match the anchor to the chain: anchor-bone strength must exceed suture strength, which must exceed tissue strength — if any link is undersized for the application (e.g., a mini anchor in high-load rotator cuff repair), the construct fails predictably.
When using anchors arthroscopically or at oblique angles, eyelet geometry matters: out-of-plane suture exit can reduce effective suture strength by nearly three-quarters, which is why smooth, non-channeled eyelets and knotless designs have displaced early sharp-eyelet anchors in high-demand repairs.