In vitro performance of a biodegradable zinc alloy adjustable-loop cortical suspension fixation for anterior cruciate ligament reconstruction

Anterior cruciate ligament (ACL) injuries of the knee are one of the most common and serious athletic injuries. The widely used cortical suspension fixation buttons for ligament reconstruction are permanent implants, particularly those made from conventional steel or titanium alloys. In this study, a biodegradable Zn–0.45Mn–0.2Mg (ZMM42) alloy with the yield strength of 300.4 MPa and tensile strength of 329.8 MPa was prepared through hot extrusion. The use of zinc alloys in the preparation of cortical suspension fixation buttons was proposed for the first time. After 35 d of immersion in simulated body fluids, the ZMM42 alloy fixation buttons were degraded at a rate of 44 µm/a, and the fixation strength was retained (379.55 N) in the traction loops. Simultaneously, the ZMM42 alloy fixation buttons exhibited an increase in MC3T3-E1 cell viability and high antibacterial activity against Escherichia coli and Staphylococcus aureus. These results reveal the potential of biodegradable zinc alloys for use as ligament reconstruction materials and for developing diverse zinc alloy cortical suspension fixation devices.