The development of glenohumeral degeneration after shoulder instability is a well documented phenomenon in both nonoperatively and operatively managed shoulders, first described by Neer in 19821 and then further described by Samilson and Prieto as “dislocation arthropathy.”2 Prospective studies have reported this process in up to 18% of patients treated nonoperatively after a single dislocation, and up to 39% in patients with multiple dislocations.3 Overall, incidence rates with or without surgical stabilization has varied greatly in the literature, ranging from 12% to 59%3, 4, 5, 6, 7, 8 with risk factors including older age at time of first dislocation, number of dislocation events, increased time from dislocation event to surgery, increased number of anchors used at time of surgery, bone loss, and degree of labral damage.6,8,9 Other direct causes include cartilage toxicity from pain catheters, thermal capsulorraphy10, and implant-related arthropathy.11, 12, 13 Most commonly, development of glenohumeral arthropathy after arthroscopy is likely multifactorial.

Anchor arthropathy is a separate term used to define the development of glenohumeral arthritis after instability surgery directly related to implants and is typically relatively rare but is likely underreported. Implant-related glenohumeral arthropathy is not a newly described pathology. In 1965, open anterior capsulorrhaphy with barbed staples was reported in the US.14 As arthroscopic techniques developed, so did the implants, including cannula friendly staples. Early reports of arthroscopic stabilization with staples showed high rates of instability recurrence as well as damage related to the implanted device. Staple loosening or breakage was thought to be secondary to the thin cortical bone and the staple's inability to withstand motion.15, 16, 17 Due to these implant related issues, fixation strategies transitioned away from staples in favor of suture anchors.

Suture anchors have evolved to include many various materials including metal, poly-L-lactic acid, polyether ether ketone (PEEK), and all-suture based implants.18 Metallic suture anchors left proud have been associated with cartilage damage necessitating removal.19 Some early bioabsorbable suture anchors have also been associated with accelerated glenohumeral arthropathy.20, 21, 22 The accelerated glenohumeral arthropathy is believed to be secondary to broken or dislodged implants.21 The term suture anchor arthropathy attempts to separate arthropathy directly related to suture anchors from the known development of glenohumeral osteoarthritis from the instability itself and the glenohumeral arthropathy associated with arthroscopic repair. Diagnosis can be difficult as symptoms are not usually specific to this phenomenon and therefore a high index of suspicious is necessary in patients with issues postoperatively.