BIORESORBABLE IMPLANTS - PRACTICAL CONSIDERATIONS

Traditional metal implants, primarily used for internal fixation, have been used by the orthopedic surgeon for years. Decades of development have produced such devices for almost every conceivable need. Despite their widespread use, a relatively consistent set of problems or issu es have been identified. These include the potential for long term mig ration, breakage, stress shielding, reaction to the material, interfer ence with standard imaging techniques, and growth restriction in young patients. A number of bioresorbable polymer devices have recently bec ome available to create a viable alternative for some indications. As expected with an evolving technology, solving one set of problems has engendered another. One of the most limiting aspects of bioresorbable polymers is their inherently lower strength compared to metals. Althou gh more of an issue with some materials and applications than others, significant tissue reactions have been observed in some cases as well. This paper discusses the field of synthetic bioresorbable polymers in general, but with specific reference to those materials and devices t hat can be used in place of metal implants for internal fixation.