{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T13:44:16Z","timestamp":1779889456155,"version":"3.53.1"},"reference-count":44,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2021,7,8]],"date-time":"2021-07-08T00:00:00Z","timestamp":1625702400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Taipei Medical University\u2013Shuang Ho Hospital; Industrial Technology Research Institute","award":["201956F0020; J356EX3200"],"award-info":[{"award-number":["201956F0020; J356EX3200"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>This study evaluated the biocompatibility and biological performance of novel additive-manufactured bioabsorbable iron-based porous suture anchors (iron_SAs). Two types of bioabsorbable iron_SAs, with double- and triple-helical structures (iron_SA_2_helix and iron_SA_3_helix, respectively), were compared with the synthetic polymer-based bioabsorbable suture anchor (polymer_SAs). An in vitro mechanical test, MTT assay, and scanning electron microscope (SEM) analysis were performed. An in vivo animal study was also performed. The three types of suture anchors were randomly implanted in the outer cortex of the lateral femoral condyle. The ultimate in vitro pullout strength of the iron_SA_3_helix group was significantly higher than the iron_SA_2_helix and polymer_SA groups. The MTT assay findings demonstrated no significant cytotoxicity, and the SEM analysis showed cells attachment on implant surface. The ultimate failure load of the iron_SA_3_helix group was significantly higher than that of the polymer_SA group. The micro-CT analysis indicated the iron_SA_3_helix group showed a higher bone volume fraction (BV\/TV) after surgery. Moreover, both iron SAs underwent degradation with time. Iron_SAs with triple-helical threads and a porous structure demonstrated better mechanical strength and high biocompatibility after short-term implantation. The combined advantages of the mechanical superiority of the iron metal and the possibility of absorption after implantation make the iron_SA a suitable candidate for further development.<\/jats:p>","DOI":"10.3390\/ijms22147368","type":"journal-article","created":{"date-parts":[[2021,7,8]],"date-time":"2021-07-08T21:05:54Z","timestamp":1625778354000},"page":"7368","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Biocompatibility and Biological Performance Evaluation of Additive-Manufactured Bioabsorbable Iron-Based Porous Suture Anchor in a Rabbit Model"],"prefix":"10.3390","volume":"22","author":[{"given":"Chien-Cheng","family":"Tai","sequence":"first","affiliation":[{"name":"Internal Ph.D. Program for Cell Therapy and Regeneration Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hon-Lok","family":"Lo","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80756, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen-Kun","family":"Liaw","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan"},{"name":"Department of Orthopedics, Shuang Ho Hospital, Taipei Medical University, No. 291, Zhongzheng Rd., Zhong He Dist., New Taipei City 23561, Taiwan"},{"name":"Research Center of Biomedical Device, Graduate Institute of Biomedical Optomechatronics, College of Biomedical Engineering, Taipei Medical University, Taipei 11301, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7059-4498","authenticated-orcid":false,"given":"Yu-Min","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan"},{"name":"Department of Orthopedics, Shuang Ho Hospital, Taipei Medical University, No. 291, Zhongzheng Rd., Zhong He Dist., New Taipei City 23561, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6020-9998","authenticated-orcid":false,"given":"Yen-Hua","family":"Huang","sequence":"additional","affiliation":[{"name":"Internal Ph.D. Program for Cell Therapy and Regeneration Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan"},{"name":"Department of Biochemistry and Molecular Cell Biology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan"},{"name":"TMU Research Center of Cell Therapy and Regeneration Medicine, Taipei Medical University, Taipei 11031, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuo-Yi","family":"Yang","sequence":"additional","affiliation":[{"name":"Biomedical Technology and Device Research Laboratories, Industrial Technology Research Institute, Chutung, Hsinchu 310401, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih-Chieh","family":"Huang","sequence":"additional","affiliation":[{"name":"Biomedical Technology and Device Research Laboratories, Industrial Technology Research Institute, Chutung, Hsinchu 310401, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shin-I","family":"Huang","sequence":"additional","affiliation":[{"name":"Biomedical Technology and Device Research Laboratories, Industrial Technology Research Institute, Chutung, Hsinchu 310401, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsin-Hsin","family":"Shen","sequence":"additional","affiliation":[{"name":"Biomedical Technology and Device Research Laboratories, Industrial Technology Research Institute, Chutung, Hsinchu 310401, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tzu-Hung","family":"Lin","sequence":"additional","affiliation":[{"name":"Material and Chemical Research Laboratories, Industrial Technology Research Institute, Hsinchu 31040, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9738-6151","authenticated-orcid":false,"given":"Chun-Kuan","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Park One International Hospital, Kaohsiung 813322, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7689-8732","authenticated-orcid":false,"given":"Wen-Chih","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80756, Taiwan"},{"name":"Ph.D. Program in Biomedical Engineering, College of Medicine, Kaohsiung Medical University, Kaohsiung 807378, Taiwan"},{"name":"Regeneration Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung 807378, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jui-Sheng","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, China Medical University, Taichung 40202, Taiwan"},{"name":"School of Medicine, College of Medicine, China Medical University, Taichung 40202, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3516-3120","authenticated-orcid":false,"given":"Pei-I","family":"Tsai","sequence":"additional","affiliation":[{"name":"Biomedical Technology and Device Research Laboratories, Industrial Technology Research Institute, Chutung, Hsinchu 310401, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5508-7647","authenticated-orcid":false,"given":"Chih-Yu","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan"},{"name":"Department of Orthopedics, Shuang Ho Hospital, Taipei Medical University, No. 291, Zhongzheng Rd., Zhong He Dist., New Taipei City 23561, Taiwan"},{"name":"Research Center of Biomedical Device, Graduate Institute of Biomedical Optomechatronics, College of Biomedical Engineering, Taipei Medical University, Taipei 11301, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,7,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Park, J.B., and Bronzino, J.D. (2002). Biomaterials: Principles and Applications, CRC Press. [1st ed.].","DOI":"10.1201\/9781420040036"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"98","DOI":"10.5213\/inj.2013.17.3.98","article-title":"Development of implantable medical devices: From an engineering perspective","volume":"17","author":"Joung","year":"2013","journal-title":"Int. Neurourol. J."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Khan, W., Muntimadugu, E., Jaffe, M., and Domb, A.J. (2014). Implantable medical devices. Focal Controlled Drug Delivery, Springer.","DOI":"10.1007\/978-1-4614-9434-8_2"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1016\/j.mattod.2018.05.018","article-title":"Current status and outlook on the clinical translation of biodegradable metals","volume":"23","author":"Han","year":"2019","journal-title":"Mater. Today"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1039\/C8QM00507A","article-title":"Biodegradable metallic bone implants","volume":"3","author":"Shuai","year":"2019","journal-title":"Mater. Chem. Front."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1189","DOI":"10.1016\/S0266-3538(00)00241-4","article-title":"Biomedical applications of polymer-composite materials: A review","volume":"61","author":"Ramakrishna","year":"2001","journal-title":"Compos. Sci. Technol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1038\/s41578-019-0150-z","article-title":"Design of biodegradable, implantable devices towards clinical translation","volume":"5","author":"Li","year":"2020","journal-title":"Nat. Rev. Mater."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1002\/jbm.b.31639","article-title":"Fabrication of a biodegradable calcium polyphosphate\/polyvinyl-urethane carbonate composite for high load bearing osteosynthesis applications","volume":"94","author":"Ramsay","year":"2010","journal-title":"J. Biomed. Mater. Res. Part B Appl. Biomater."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"103572","DOI":"10.1016\/j.jmbbm.2019.103572","article-title":"Strategy to improve the mechanical properties of bioabsorbable materials based on chitosan for orthopedic fixation applications","volume":"103","author":"Figueiredo","year":"2020","journal-title":"J. Mech. Behav. Biomed. Mater."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1728","DOI":"10.1016\/j.biomaterials.2005.10.003","article-title":"Magnesium and its alloys as orthopedic biomaterials: A review","volume":"27","author":"Staiger","year":"2006","journal-title":"Biomaterials"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1680","DOI":"10.1016\/j.actbio.2010.02.028","article-title":"The history of biodegradable magnesium implants: A review","volume":"6","author":"Witte","year":"2010","journal-title":"Acta Biomater."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/srep11194","article-title":"Controlling the degradation kinetics of porous iron by poly (lactic-co-glycolic acid) infiltration for use as temporary medical implants","volume":"5","author":"Yusop","year":"2015","journal-title":"Sci. Rep."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Gorejov\u00e1, R., Ori\u0148akov\u00e1, R., Ors\u00e1gov\u00e1 Kr\u00e1lov\u00e1, Z., Bal\u00e1\u017e, M., Kupkov\u00e1, M., Hrubov\u010d\u00e1kov\u00e1, M., Haverov\u00e1, L., D\u017eupon, M., Ori\u0148ak, A., and Ka\u013eavsk\u00fd, F. (2020). In vitro corrosion behavior of biodegradable iron foams with polymeric coating. Materials, 13.","DOI":"10.3390\/ma13010184"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"3346","DOI":"10.1016\/j.actbio.2014.04.007","article-title":"Biodegradable Fe-based alloys for use in osteosynthesis: Outcome of an in vivo study after 52 weeks","volume":"10","author":"Kraus","year":"2014","journal-title":"Acta Biomater."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s10856-015-5473-8","article-title":"Iron and iron-based alloys for temporary cardiovascular applications","volume":"26","author":"Francis","year":"2015","journal-title":"J. Mater. Sci. Mater. Med."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Zivic, F., Grujovic, N., Pellicer, E., Sort, J., Mitrovic, S., Adamovic, D., and Vulovic, M. (2018). Biodegradable metals as biomaterials for clinical Practice: Iron-based materials. Biomaterials in Clinical Practice, Springer International Publishing. [1st ed.].","DOI":"10.1007\/978-3-319-68025-5_9"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1016\/j.actbio.2016.08.032","article-title":"Binder-jetting 3D printing and alloy development of new biodegradable Fe-Mn-Ca\/Mg alloys","volume":"45","author":"Hong","year":"2016","journal-title":"Acta Biomater."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1882","DOI":"10.1016\/j.msec.2012.10.013","article-title":"Degradation performance of biodegradable FeMnC (Pd) alloys","volume":"33","author":"Schinhammer","year":"2013","journal-title":"Mater. Sci. Eng. C"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2277","DOI":"10.1002\/jbm.a.34882","article-title":"Microstructure, mechanical property, biodegradation behavior, and biocompatibility of biodegradable Fe\u2013Fe2O3 composites","volume":"102","author":"Cheng","year":"2014","journal-title":"J. Biomed. Mater. Res. Part A"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2633","DOI":"10.1002\/jor.24037","article-title":"Improvement of bone-tendon fixation by porous titanium interference screw: A rabbit animal model","volume":"36","author":"Tsai","year":"2018","journal-title":"J. Orthop. Res."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1016\/j.actbio.2020.11.022","article-title":"Extrusion-based 3D printed biodegradable porous iron","volume":"121","author":"Putra","year":"2021","journal-title":"Acta Biomater."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1039\/C4BM00291A","article-title":"Bone tissue regeneration: The role of scaffold geometry","volume":"3","author":"Zadpoor","year":"2015","journal-title":"Biomater. Sci."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41598-020-66289-y","article-title":"Development of a novel biodegradable porous iron-based implant for bone replacement","volume":"10","author":"Wegener","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"952","DOI":"10.1016\/j.arthro.2019.11.119","article-title":"Bony ingrowth of coil-type open-architecture anchors compared with screw-type PEEK anchors for the medial row in rotator cuff repair: A randomized controlled trial","volume":"36","author":"Chahla","year":"2020","journal-title":"Arthrosc. J. Arthrosc. Relat. Surg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1016\/j.arthro.2019.08.049","article-title":"A comparison of open-construct PEEK suture anchor and non-vented biocomposite suture anchor in arthroscopic rotator cuff repair: A prospective randomized clinical trial","volume":"36","author":"Kim","year":"2020","journal-title":"Arthrosc. J. Arthrosc. Relat. Surg."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1392","DOI":"10.1177\/0363546512441589","article-title":"Bone replacement of fast-absorbing biocomposite anchors in arthroscopic shoulder labral repairs","volume":"40","author":"Milewski","year":"2012","journal-title":"Am. J. Sports Med."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Prabhu, B., Karau, A., Wood, A., Dadsetan, M., Liedtke, H., and DeWitt, T. (2018). Bioresorbable Materials for Orthopedic Applications (Lactide and Glycolide Based). Orthopedic Biomaterials, Springer.","DOI":"10.1007\/978-3-319-89542-0_13"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/j.jconrel.2019.05.003","article-title":"Injectable, long-acting PLGA formulations: Analyzing PLGA and understanding microparticle formation","volume":"304","author":"Park","year":"2019","journal-title":"J. Control. Release"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Yamauchi, S., Tsukada, H., Sasaki, E., Sasaki, S., Kimura, Y., Yamamoto, Y., Tsuda, E., and Ishibashi, Y. (2021). Biomechanical analysis of bioabsorbable suture anchors for rotator cuff repair using osteoporotic and normal bone models. J. Orthop. Sci.","DOI":"10.1016\/j.jos.2020.11.017"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1913","DOI":"10.1007\/s10853-018-3011-z","article-title":"Recent advancements in Fe-based biodegradable materials for bone repair","volume":"54","year":"2019","journal-title":"J. Mater. Sci."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"10","DOI":"10.3415\/VCOT-17-06-0080","article-title":"In vivo evaluation of biodegradability and biocompatibility of Fe30Mn alloy","volume":"31","author":"Traverson","year":"2018","journal-title":"Vet. Comp. Orthop. Traumatol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1007\/s40204-018-0091-4","article-title":"Updates on the research and development of absorbable metals for biomedical applications","volume":"7","author":"Hermawan","year":"2018","journal-title":"Prog. Biomater."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"4955","DOI":"10.1016\/j.biomaterials.2006.05.029","article-title":"Long-term biocompatibility of a corrodible peripheral iron stent in the porcine descending aorta","volume":"27","author":"Peuster","year":"2006","journal-title":"Biomaterials"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1016\/j.msec.2017.12.021","article-title":"Biodegradable nanostructures: Degradation process and biocompatibility of iron oxide nanostructured arrays","volume":"85","author":"Yang","year":"2018","journal-title":"Mater. Sci. Eng. C"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.clinbiomech.2018.11.008","article-title":"The history of suture anchors in orthopaedic surgery","volume":"61","author":"Visscher","year":"2019","journal-title":"Clin. Biomech."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"832","DOI":"10.1016\/j.arthro.2013.01.028","article-title":"Cyclic loading biomechanical analysis of the pullout strengths of rotator cuff and glenoid anchors: 2013 update","volume":"29","author":"Barber","year":"2013","journal-title":"Arthrosc. J. Arthrosc. Relat. Surg."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/j.mporth.2016.12.001","article-title":"A review of suture anchors","volume":"33","author":"Chaudhry","year":"2019","journal-title":"Orthop. Trauma"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"3318","DOI":"10.1002\/jor.24135","article-title":"Effect of structural design on the pullout strength of suture anchors for rotator cuff repair","volume":"36","author":"Chae","year":"2018","journal-title":"J. Orthop. Res.\u00ae"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.arthro.2016.05.040","article-title":"Suture anchor fixation in osteoporotic bone: A biomechanical study in an ovine model","volume":"33","author":"Horoz","year":"2017","journal-title":"Arthrosc. J. Arthrosc. Relat. Surg."},{"key":"ref_40","first-page":"1","article-title":"Tailoring grain sizes of the biodegradable iron-based alloys by pre-additive manufacturing microalloying","volume":"11","author":"Huang","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1053\/jars.2002.25966","article-title":"The influence of mechanical stress on graft healing in a bone tunnel","volume":"18","author":"Yamakado","year":"2002","journal-title":"Arthrosc. J. Arthrosc. Relat. Surg."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/j.matchar.2013.11.004","article-title":"The effect of spatial micro-CT image resolution and surface complexity on the morphological 3D analysis of open porous structures","volume":"87","author":"Pyka","year":"2014","journal-title":"Mater. Charact."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1120","DOI":"10.1021\/acs.chemmater.9b04047","article-title":"Fabrication of asymmetrical and gradient hierarchy structures of poly-p-xylylenes on multiscale regimes based on a vapor-phase sublimation and deposition process","volume":"32","author":"Chiu","year":"2020","journal-title":"Chem. Mater."},{"key":"ref_44","unstructured":"Van Dalen, G., and Koster, M. (2012, January 13). 2D & 3D particle size analysis of micro-CT images. Proceedings of the Bruker Micro-CT User Meeting, Brussels, Belgium."}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/22\/14\/7368\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:28:04Z","timestamp":1760164084000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/22\/14\/7368"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,8]]},"references-count":44,"journal-issue":{"issue":"14","published-online":{"date-parts":[[2021,7]]}},"alternative-id":["ijms22147368"],"URL":"https:\/\/doi.org\/10.3390\/ijms22147368","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,8]]}}}