Biodegradable Implants

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SummaryBiodegradable or bioresorbable implants, primarily polylactic acid, polyglycolic acid, and polydioxanone have recently been used for soft tissue fixation in sports medicine. All three are high molecular weight polymers, which are self-reinforced in most instances. Their advantages include resorption over time, load sharing, elimination of magnetic resonance imaging artifacts, drill-through capabilities for ligament graft revision, multitasking, and little need for implant removal. Adverse effects have included synovitis, foreign body reaction, fistula formation, breakage, and loss of fixation. The length of time until implant degradation is a defining characteristic of the individual material. The mechanical properties decline in advance and parallel to the time of degradation. Material and structural properties can be tailored to clinical requirements during manufacturing. Biodegradable interference screws are being used for clinical applications, including cruciate ligament reconstruction. The meniscus arrow implant is beginning to be evaluated for meniscus repair. Existing biodegradable pins have been applied to the stabilization of osteochondral lesions. One brand, Suretac, has been extensively used in shoulder labral reconstruction because of its ease of use and arthroscopic utility. Biodegradable suture anchors are undergoing clinical evaluation in shoulder reconstruction involving the labrum and rotator cuff. Multitasking of biodegradable implants by incorporating pharmaceuticals or growth factors is a potential use of these implants.

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