Degradable polymeric materials for osteosynthesis: tutorial.

This report summarizes the state of the art and recent developments and advances in the use of degradable polymers devices for osteosynthesis. The current generation of biodegradable polymeric implants for bone repair utilising designs copied from metal implants, originates from the concept that devices should be supportive and as "inert" substitute to bone tissue. Today degradable polymeric devices for osteosynthesis are successful in low or mild load bearing applications. However, the lack of carefully controlled randomized prospective trials that document their efficacy in treating a particular fracture pattern is still an issue. Then, the choice between degradable and non-degradable devices must be carefully weighed and depends on many factors such as the patient age and condition, the type of fracture, the risk of infection, etc. The improvement of the biodegradable devices mechanical properties and their degradation behaviour will have to be achieved to broaden their use. The next generation of biodegradable implants will probably see the implementation of the recent gained knowledge in cell-material interactions and cells therapy, with a better control of the spatial and temporal interfaces between the material and the surrounding bone tissue.