One of the most common questions in choosing a suture anchor is: PEEK or titanium? Each material has its own advantages.
Characteristics of titanium anchors
Titanium (usually Ti6Al4V ELI, ASTM F136) has high pull-out strength and proven biocompatibility. It is preferred where strong hold is required. Its drawback is that it can cause metal artefacts in magnetic resonance (MR) and CT imaging.
Titanium also offers high fatigue resistance and dimensional stability. This allows even thin-walled, small-diameter anchor geometries to be manufactured to tight tolerances. The Ti6Al4V ELI alloy is a well-established material class used in orthopedic implant manufacturing for many years.
Characteristics of PEEK anchors
PEEK is an implant-grade polymer and is radiolucent — meaning it does not create metal-like shadows or artefacts in imaging. This is an advantage in cases where post-operative follow-up imaging matters. Its strength profile differs from titanium, but modern PEEK anchors are designed to meet clinical requirements.
Another characteristic of PEEK is that its elastic modulus is closer to that of bone than metals are. Material selection is therefore based not only on strength figures, but also on how the implant and the surrounding bone behave together.
Comparison summary
- Strength: titanium generally has higher pull-out strength.
- Imaging: PEEK is radiolucent; titanium may create artefacts.
- Biocompatibility: both are implant-grade and biocompatible.
- Revision: radiolucent material is designed to make assessment of the repair site easier in subsequent imaging.
- Hybrid solutions: some products combine a PEEK body with a titanium tip. E.g. Titanium Peek Knotless Pushlock.
Why do hybrid designs exist?
Because PEEK and titanium have different strengths, some products combine both materials in a single implant. The typical approach is to produce the body from radiolucent PEEK and the tip that makes first contact with bone from titanium. This is designed to keep the metal volume in imaging limited while preserving the stiffness needed during insertion.
Hybrid solutions show that the material discussion is often not an either/or question. The design is built by deciding which part of the implant benefits from each material's contribution.
How does bone quality affect the choice?
The material discussion usually only makes sense alongside bone quality. In bone of good density, both materials can work to create a strong fixation. Where bone density is low, what determines hold is often not the material itself but the anchor's geometry, thread structure and contact surface. It is therefore more accurate to frame the comparison as "which design suits this case" rather than "which material is better".
The suture is part of the choice too
The behaviour of the repair construct is determined as much by the suture as by the anchor body material. High-strength braided sutures contribute to the system through their knot-holding and load-bearing characteristics. In knotless designs, how the suture locks inside the anchor comes to the fore. Anchor and suture are therefore treated not as separate products but as a system evaluated together.
Differences on the manufacturing side
The two materials require different machining parameters. Titanium demands careful process control in terms of cutting speeds and tool life, while PEEK is machined with a different strategy because of its thermal behaviour. For both materials, surface quality, deburring control and cleaning steps are critical processes documented under ISO 13485.
Which one to choose?
There is no single answer; bone quality, joint, imaging needs and surgical technique are decisive. This decision rests with the relevant healthcare professional. Maxx Global Medical manufactures both titanium and PEEK anchors; explore the suture anchor family.
You may also want to read our more introductory article, What Is a Suture Anchor?
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