Comparing Biomechanical Properties of Bioabsorbable Suture Anchors: A Comprehensive Review

Suture anchors (SAs) are medical devices used to connect soft tissue to bone. Traditionally these were made of metal; however, in the past few decades, bio-absorbable suture anchors have been created to overcome revision surgeries and other complications caused by metallic SAs. This systematic revie...

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Main Authors: Dorien I. Schonebaum, Noelle Garbaccio, Maria J. Escobar-Domingo, Sasha Wood, Jade. E. Smith, Lacey Foster, Morvarid Mehdizadeh, Justin J. Cordero, Jose A. Foppiani, Umar Choudry, David L. Kaplan, Samuel J. Lin
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Language:English
Published: MDPI AG 2025-03-01
Series:Biomimetics
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Online Access:https://www.mdpi.com/2313-7673/10/3/175
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author Dorien I. Schonebaum
Noelle Garbaccio
Maria J. Escobar-Domingo
Sasha Wood
Jade. E. Smith
Lacey Foster
Morvarid Mehdizadeh
Justin J. Cordero
Jose A. Foppiani
Umar Choudry
David L. Kaplan
Samuel J. Lin
author_facet Dorien I. Schonebaum
Noelle Garbaccio
Maria J. Escobar-Domingo
Sasha Wood
Jade. E. Smith
Lacey Foster
Morvarid Mehdizadeh
Justin J. Cordero
Jose A. Foppiani
Umar Choudry
David L. Kaplan
Samuel J. Lin
author_sort Dorien I. Schonebaum
collection DOAJ
description Suture anchors (SAs) are medical devices used to connect soft tissue to bone. Traditionally these were made of metal; however, in the past few decades, bio-absorbable suture anchors have been created to overcome revision surgeries and other complications caused by metallic SAs. This systematic review aims to analyze the biomechanical properties of these SAs to gain a better understanding of their safety and utilization. A comprehensive systematic review that adhered to the PRISMA guidelines was conducted. Primary outcomes were that the pull-out strength of SAs, the rate of degradation secondarily, and the biocompatibility of all SAs were analyzed. After screening 347 articles, 16 were included in this review. These studies revealed that the pull-out strength of bio-absorbable SAs was not inferior to that of their non-absorbable comparatives. The studies also revealed that the rate of degradation varies widely from 7 to 90 months. It also showed that not all absorbable SAs were fully absorbed within the expected timeframe. This systematic review demonstrates that existing suture anchor materials exhibit comparable pull-out strengths, material-specific degradation rates, and variable biocompatibility. All-suture anchors had promising results in biocompatibility, but evidence fails to identify a single most favorable material. Higher-powered studies that incorporate tissue-specific characteristics, such as rotator cuff tear size, are warranted. To meet demonstrated shortcomings in strength and biocompatibility, we propose silk fibroin as a novel material for suture anchor design for its customizable properties and superior strength.
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spelling doaj-art-80f0ed68c06443f5b0c8afbae37c36232025-08-20T03:43:21ZengMDPI AGBiomimetics2313-76732025-03-0110317510.3390/biomimetics10030175Comparing Biomechanical Properties of Bioabsorbable Suture Anchors: A Comprehensive ReviewDorien I. Schonebaum0Noelle Garbaccio1Maria J. Escobar-Domingo2Sasha Wood3Jade. E. Smith4Lacey Foster5Morvarid Mehdizadeh6Justin J. Cordero7Jose A. Foppiani8Umar Choudry9David L. Kaplan10Samuel J. Lin11Department of Plastic and Reconstructive Surgery, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA 02215, USADepartment of Plastic and Reconstructive Surgery, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA 02215, USADepartment of Plastic and Reconstructive Surgery, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA 02215, USADepartment of Plastic and Reconstructive Surgery, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA 02215, USADepartment of Plastic and Reconstructive Surgery, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA 02215, USADepartment of Plastic and Reconstructive Surgery, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA 02215, USADepartment of Plastic and Reconstructive Surgery, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA 02215, USADepartment of Plastic and Reconstructive Surgery, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA 02215, USADepartment of Plastic and Reconstructive Surgery, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA 02215, USADepartment of Plastic and Reconstructive Surgery, University of Minnesota, Minneapolis, MN 55455, USADepartment of Biomedical Engineering, Tufts University, Medford, MA 02155, USADepartment of Plastic and Reconstructive Surgery, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA 02215, USASuture anchors (SAs) are medical devices used to connect soft tissue to bone. Traditionally these were made of metal; however, in the past few decades, bio-absorbable suture anchors have been created to overcome revision surgeries and other complications caused by metallic SAs. This systematic review aims to analyze the biomechanical properties of these SAs to gain a better understanding of their safety and utilization. A comprehensive systematic review that adhered to the PRISMA guidelines was conducted. Primary outcomes were that the pull-out strength of SAs, the rate of degradation secondarily, and the biocompatibility of all SAs were analyzed. After screening 347 articles, 16 were included in this review. These studies revealed that the pull-out strength of bio-absorbable SAs was not inferior to that of their non-absorbable comparatives. The studies also revealed that the rate of degradation varies widely from 7 to 90 months. It also showed that not all absorbable SAs were fully absorbed within the expected timeframe. This systematic review demonstrates that existing suture anchor materials exhibit comparable pull-out strengths, material-specific degradation rates, and variable biocompatibility. All-suture anchors had promising results in biocompatibility, but evidence fails to identify a single most favorable material. Higher-powered studies that incorporate tissue-specific characteristics, such as rotator cuff tear size, are warranted. To meet demonstrated shortcomings in strength and biocompatibility, we propose silk fibroin as a novel material for suture anchor design for its customizable properties and superior strength.https://www.mdpi.com/2313-7673/10/3/175suture anchorabsorbable suturenon-absorbable sutureall-softall-suturesilk
spellingShingle Dorien I. Schonebaum
Noelle Garbaccio
Maria J. Escobar-Domingo
Sasha Wood
Jade. E. Smith
Lacey Foster
Morvarid Mehdizadeh
Justin J. Cordero
Jose A. Foppiani
Umar Choudry
David L. Kaplan
Samuel J. Lin
Comparing Biomechanical Properties of Bioabsorbable Suture Anchors: A Comprehensive Review
Biomimetics
suture anchor
absorbable suture
non-absorbable suture
all-soft
all-suture
silk
title Comparing Biomechanical Properties of Bioabsorbable Suture Anchors: A Comprehensive Review
title_full Comparing Biomechanical Properties of Bioabsorbable Suture Anchors: A Comprehensive Review
title_fullStr Comparing Biomechanical Properties of Bioabsorbable Suture Anchors: A Comprehensive Review
title_full_unstemmed Comparing Biomechanical Properties of Bioabsorbable Suture Anchors: A Comprehensive Review
title_short Comparing Biomechanical Properties of Bioabsorbable Suture Anchors: A Comprehensive Review
title_sort comparing biomechanical properties of bioabsorbable suture anchors a comprehensive review
topic suture anchor
absorbable suture
non-absorbable suture
all-soft
all-suture
silk
url https://www.mdpi.com/2313-7673/10/3/175
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