Biodegradable implants in soft tissue refixation: Experimental evaluation, clinical experience, and future needs

Abstract

In recent years there has been an increasing use of biodegradable implants in the wide field of operative sports medicine for the reattachment of ligaments, tendons and other structures. A great variety of implants are available as interference screws, staples, sutures, tacks, arrows and suture anchors. The main advantages of biodegradable implants are no need for implant removal, undistorted MRI imaging and uncompromised revision surgery. There are many indications for biodegradable implants: in shoulder surgery for treatment of Bankart lesions and in the knee joint for cruciate ligament and meniscal surgery with either arthroscopic or open surgical application techniques. In general, biodegradable implants seem to be safe and effective for the refixation of soft tissues. However, various materials are on the market for which no clinical or experimental long-term data on soft tissue or bone reaction is available. In the last few years there has been a large number of reports on osseous and intraarticular soft tissue reactions, e.g. synovitis due to intraarticular use of biodegradable implants. Therefore, the clinical use of biodegradable implants should be controlled by clinical and radiological long-term follow-up. From the variety of implants offered one should carefully select the right implant to address the indication: the mechanical and degradation characteristics, easy and safe handling, adequate initial strength and sufficient strength during the repair process to enable safe and fast tissue healing until full patient recovery.