Anchor technology has evolved significantly in arthroscopic surgery, aiming to improve fixation strength, surgical efficiency, and biological compatibility. Among modern solutions, self-punching PEEK + Titanium Knotless have gained increasing acceptance due to their hybrid material design and streamlined insertion technique.

These anchors combine the cutting efficiency of a titanium tip with the biomechanical compatibility of a PEEK body, offering both surgical convenience and reliable long-term fixation.

What Is a Self-Punching PEEK + Titanium Anchor?

A self-punching PEEK + Titanium anchor is a hybrid fixation implant featuring:

• Titanium distal tip that penetrates cortical bone without pre-drilling or tapping

• PEEK (Polyether Ether Ketone) body that provides elastic modulus closer to bone

  The titanium tip initiates bone entry, while the PEEK body engages cancellous bone through controlled screw advancement.

Key Advantages

1. Elimination of Pre-Drilling and Tapping

The sharp titanium tip allows direct insertion into bone, reducing surgical steps.

Clinical advantages:

• Shorter operative time

• Fewer instruments required

• Reduced risk of bone tunnel mismatch

This is particularly beneficial in small joint arthroscopy and minimally invasive procedures.

2. Optimized Biomechanical Load Distribution

PEEK has an elastic modulus closer to cortical bone compared to metals.

Result:

• Reduced stress shielding

• More physiological load transfer

• Lower risk of microfracture around the anchor site

Studies show that polymer-based anchor bodies demonstrate favorable cyclic loading behavior compared to fully metallic anchors.

3. High Initial Fixation Strength

The titanium tip ensures secure cortical engagement at insertion, while the PEEK screw threads maintain fixation within cancellous bone.

Biomechanical testing has demonstrated:

• High pull-out resistance

• Stable performance under cyclic loading

• Consistent fixation even in lower bone density scenarios

4. Reduced Risk of Implant Breakage

Unlike fully metallic anchors, hybrid designs reduce peak insertion torque.

• Titanium tip cuts bone efficiently

• PEEK body lowers torsional stress during advancement

This combination significantly decreases anchor fracture risk during insertion, a known complication with rigid metal anchors.

5. Imaging Compatibility

PEEK is radiolucent, producing minimal artifact on MRI and CT.

Clinical benefits include:

• Clear postoperative imaging

• Improved assessment of soft tissue healing

• Easier evaluation in revision surgery planning

The small titanium tip does not significantly compromise imaging quality.

6. Suitability for Knotless Fixation Systems

Self-punching PEEK + Titanium anchors are well suited for knotless arthroscopic techniques, which:

• Eliminate knot stacks

• Reduce soft-tissue irritation

• Provide reproducible tension control

Knotless constructs are increasingly preferred in shoulder, labral, and small joint procedures.

Common Clinical Applications

These anchors are widely used in:

• Rotator cuff repair

• Labral repair (Bankart lesions)

• SLAP repairs

• Small joint arthroscopy (wrist, ankle, elbow)

• Soft tissue reattachment requiring precise fixation

Conclusion

Self-punching PEEK + Titanium Knotless anchors represent a next-generation fixation solution, combining the mechanical reliability of titanium with the biological and imaging advantages of PEEK.

By simplifying surgical workflow, enhancing fixation safety, and supporting modern knotless techniques, these anchors offer a balanced and surgeon-oriented approach to arthroscopic fixation.