As we mentioned in a previous post, most suture anchors stay in your bone for life. The technology has advanced to such a degree, that they are extraordinarily reliable and rarely come out.
While we don’t have exact numbers, our experience as surgeons tells us that it is rare for them to “back-out” of bone as we just do not see it that commonly in our practices.
Why Are Suture Anchors Used in Shoulder Surgery?
Suture anchors are small devices used to attach soft tissue (like tendons or ligaments) to bone. They are critical tools in modern orthopedic procedures, particularly in rotator cuff repairs, labral repairs, and instability surgeries. By providing a stable fixation point, they allow tissues to heal back to bone properly, which is essential for long-term success.
Types of Suture Anchors
We live in a world with many options: anchors made of metal, plastic, all-suture, and biocomposite materials. Each has its own strengths and specific use cases:
- Metal anchors: Durable and highly visible on imaging but permanent.
- Plastic anchors: Non-metallic, often radiolucent.
- All-suture anchors: Flexible and small, ideal for tight spaces or minimal bone disruption.
- Biocomposite anchors: Designed to slowly turn into bone over time, offering long-term integration with native bone.
Each of these has a role depending on the patient’s anatomy, age, activity level, and bone quality.
What If Anchors Do Come Out?
There are times when anchors may not last forever. Busy shoulder surgeons have all seen anchors that have backed out of bone.
Anchors may come out of bone for one of two main reasons:
- The anchor broke or malfunctioned.
- The bone failed.
The good news is that this is rare, very rare. Many new anchors are actually made of a bone-like material that turns into real bone slowly over time. So as long as the surgeon initially places the anchor well into bone, it will slowly become your own bone.
Bone Quality Matters
Sometimes bone is just too weak to hold anchors well. Again, this is relatively rare since the technology has advanced to the point where there are anchors for all types of bone. Osteoporotic or previously injured bone may present a challenge, but modern anchors are often designed specifically for such conditions.
If the bone is too weak, the surgeon will usually be able to recognize this at the time of surgery and use a special strategy to accommodate for the weak bone. This may include using multiple anchors, switching to a different anchor type, or even augmenting the bone.
Can a Loose Anchor Cause Problems?
What if an anchor does break or back out? In rare cases, this may cause local tissue irritation. If the anchor becomes too prominent and it is near cartilage, it is possible to damage the cartilage. In such instances, patients may feel pain, clicking, or swelling.
Surgeons can typically identify this on imaging and may choose to remove or revise the anchor during a follow-up procedure if symptoms persist. That said, it’s important to understand this is the exception, not the rule.
Do Anchors Affect Future Surgeries?
Many patients ask whether suture anchors can interfere with future surgeries. Generally, they do not. Biocomposite and all-suture anchors typically integrate with bone or are small enough not to interfere. Metal anchors may need to be worked around, but experienced surgeons can usually navigate this without issue.
In revision cases where previous anchors failed or loosened, surgeons will often assess the condition of the bone and determine whether to reuse existing holes, remove old anchors, or change the surgical plan. Advanced imaging helps guide these decisions.
Can You Feel an Anchor in Your Shoulder?
In almost all cases, patients do not feel their anchors. These devices are small and embedded deep in bone. However, in rare scenarios where an anchor backs out or is placed too superficially, it could become palpable or irritating. This might warrant additional evaluation.
What Makes Anchor Technology So Reliable Today?
Anchor design has come a long way in the past 20 years. Innovations include:
- Threaded designs that lock more securely into bone.
- Materials that promote bone growth or minimize inflammation.
- Smaller sizes that still offer strong fixation.
- Instruments that allow for more accurate placement.
These advances, combined with better imaging and surgical techniques, have drastically reduced complications.
What Should Patients Watch For After Surgery?
After surgery, it’s normal to have some discomfort as tissues heal. However, signs that something may be wrong include:
- Persistent or worsening pain
- Clicking or popping sensations
- Unexplained swelling
- Weakness or instability
If these symptoms arise, it’s important to follow up with your orthopedic surgeon. Imaging studies such as X-rays or MRIs may help determine if an anchor has moved or failed.
How Does Dr. DiPaola Approach Anchor Use?
At Dr. Matthew DiPaola’s practice, every surgical plan is tailored to the patient. Anchor type, placement, and surgical strategy are selected based on each individual’s anatomy, injury, and bone quality. With more than 20 years of specialized experience in shoulder and elbow surgery, Dr. DiPaola utilizes the latest technologies while also relying on sound surgical principles.
He also takes time to educate patients about what to expect before and after surgery, including discussing the type of anchors used and why. Patients are encouraged to ask questions, and many find reassurance in knowing their procedure is grounded in both research and experience.
When Should You Seek a Second Opinion?
If you’ve had shoulder surgery in the past and are experiencing unexplained symptoms or ongoing pain, it may be worth seeking a second opinion. Not all anchor issues require surgery, but a skilled evaluation can help clarify the next steps. Dr. DiPaola frequently evaluates complex and revision cases from across Western New York and beyond.
Anchors Are Safe and Effective When Used Correctly
Suture anchors are a cornerstone of modern orthopedic surgery. While anchor failure can happen, it is rare and often manageable. The combination of advanced materials, expert technique, and individualized care makes complications uncommon. With the right surgeon and the right strategy, most patients can expect long-term stability and a full return to function.
If you have concerns about a previous surgery or want to learn more about shoulder repair options, schedule a consultation with Dr. DiPaola. He offers thorough evaluations and trusted care at locations in Williamsville, Orchard Park, and Niagara Falls.