| 1 | Define the tissue and repair site before selecting the anchor. | Rotator cuff, labral, meniscal, ligament, tendon, or osteochondral repair. | Small-diameter anchor for limited bone stock; larger or multi-anchor constructs for higher-load repairs where clinically appropriate. | Metallic, polymeric, bioabsorbable, or biocomposite options may be available. Selection should match bone quality, healing objectives, and the device instructions for use. | Confirm the number of suture limbs, suture size, suture type, and whether the construct supports simple, mattress, or rip-stop configurations. | Anchor diameter, insertion depth, thread design, pullout or fixation data, and compatibility with the intended repair technique. | Match the anchor to the anatomical site, bone density, repair pattern, and surgeon-defined fixation plan. |
| 2 | Match the fixation method to the surgical approach and available working space. | Arthroscopic shoulder, hip, knee, ankle, hand, foot, or open soft-tissue procedures. | Preloaded anchors can reduce handling steps; knotless anchors can simplify tensioning; knotted anchors may provide suture-tension flexibility. | Select radiopaque or radiolucent characteristics according to postoperative imaging needs and the relevant device documentation. | Verify suture management features, loading sequence, eyelet or channel design, and whether the sutures are color-coded for handling. | Delivery-system diameter, insertion angle, cannula compatibility, drill or punch requirements, and access limitations. | Confirm that the delivery instrument fits the portal, incision, guide, and planned trajectory. |
| 3 | Assess bone quality and the expected mechanical demand of the repair. | Osteoporotic bone, revision surgery, high-tension tendon repair, or ligament reconstruction. | Consider screw-in or other insertion designs that provide appropriate engagement for the documented bone conditions and surgical technique. | Material stiffness, thread geometry, insertion torque, and potential degradation profile should be reviewed together rather than in isolation. | Use the suture size and construction supported by the anchor's validated mechanical data; avoid assuming that a larger suture always improves fixation. | Indicated bone quality, insertion torque range where provided, cyclic loading results, pullout data, and recommended drilling protocol. | Review mechanical testing conditions and confirm that they are relevant to the planned anatomical site and repair construct. |
| 4 | Consider imaging, revision, and long-term follow-up requirements. | Patients likely to require MRI follow-up, revision surgery, or evaluation of postoperative bone and soft tissue. | Select the anchor type according to its imaging labeling, removability, visibility, and intended permanence. | Metallic anchors may create susceptibility artifact; polymeric and bioabsorbable materials may offer different imaging characteristics. Always verify the specific MR labeling. | Confirm whether the suture is intended to remain permanently and whether it has features that support later identification or retrieval. | MR safety status, conditional scanning limits, artifact information, radiographic visibility, and revision procedure guidance. | Obtain the current MR conditions and implant identification information before purchase and clinical use. |
| 5 | Verify regulatory, sterilization, and supply requirements for the intended use. | Routine primary repair, urgent cases, ambulatory surgery, hospital procurement, or multi-site inventory management. | Sterile, single-use anchors with procedure-specific instruments and clearly defined indications. | Check biocompatibility information, sterilization method, shelf life, packaging integrity, and storage conditions. | Confirm the supplied suture is sterile, securely attached, correctly labeled, and included in the approved device configuration. | Intended-use statement, anatomical indications, contraindications, lot traceability, expiration date, and instrument availability. | Purchase only products cleared or approved for the relevant market and use them according to the current instructions for use. |