A novel design magnesium alloy suture anchor promotes fibrocartilaginous enthesis regeneration in rabbit rotator cuff repair

Regarding the current materials used for suture anchors for rotator cuff repair, there are still limitations in terms of degradability, mechanical properties, and bioactivities in clinical applications. Magnesium alloys have preliminarily been shown to promote tendon-bone healing with good prospects for application as anchor materials. However, the design of anchor structures for the degradation characteristics of magnesium alloy materials has not been considered, which is critical for the practical application of magnesium alloy anchors. The mechanism by which magnesium promotes tendon bone healing remains to be clarified. Here, we proposed a novel split hollowed magnesium alloy suture anchors for the repair of rabbit rotator cuff injury. We found that novel split hollowed magnesium alloy anchors structure effectively solved the problem of failure due to degradation of traditional eyelet structure, providing reliable suture fixation. The open architecture facilitates the metabolic resorption of the degradation products of and promotes the ingrowth of bone tissue. Histological staining showed that magnesium anchors have better ability to promote regeneration at the fibrocartilage interface compared to PLLA anchors. The higher expression of fibrocartilage markers (Aggrecan, COL2A1, and Sox9) at the tendon-bone interface in magnesium anchors, which promotes chondrocyte differentiation at the tendon-bone interface and matrix formation, which is more conducive to achieving regeneration and maturation of fibrocartilage enthesis. Hence, this study provides a basis for further research on the clinical application of degradable magnesium alloy suture anchors.