ecently, bioabsorbable suture anchors have been utilized for many applications in shoulder surgery, including rotator cuff repair and capsulolabral repair 1 . Bioabsorbable anchors were developed to provide secure reattachment of avulsed soft tissues to their osseous insertions while allowing eventual implant degradation and replacement by autogenous tissue 2 . Although bioabsorbable materials offer some advantages, their use is not without complications. Foreign-body reactions, osteolysis, and synovitis have been described after use of biodegradable polyglycolic acid implants in the shoulder 3-5 . The next-generation, poly(L-lactide) polymer implants were initially described as being well tolerated without apparent complications of lysis, loosening, or synovitis 1,6,7 . Poly(L-lactide) was also found to degrade much more slowly than polyglycolic acid, with the time to complete degradation estimated to be more than three years in animal models 8 . Furthermore, poly(L-lactide) implants were thought to have better biocompatibility than polyglycolic acid implants 1,6 . In 2003, Freehill et al. 9 reported similar complications, consisting of glenohumeral synovitis and chondral damage, with poly(Llactide) tacks.The Bioknotless suture anchor (Mitek, Norwood, Massachusetts), which is constructed of poly(L-lactide) polymer, has been reported to be a secure, reliable, and efficient means of fixation for superior labrum anterior-posterior (SLAP) lesions and Bankart lesions 7 . The senior author (S.W.O'D.) implanted Bioknotless anchors in twenty-five shoulders in twenty-five patients for repair of SLAP and/or Bankart lesions. The purpose of this study is to report on four of these patients, who had failure of the Bioknotless device that led to destructive glenoid osteolysis, anchor pull-out, and subsequent severe damage of the articular cartilage. The patients were informed that data concerning their cases would be submitted for publication.
