Biodegradable implants in sports medicine: the biological base

Biodegradable implants are increasingly used in the field of operative sports medicine. Today, a tremendous variety of implants such as interference screws, staples, sutures, tacks, suture anchors, and devices for meniscal repair are available. These implants consist of different biodegradable polymers that have substantially different raw material characteristics such as in vivo degradation, host-tissue response, and osseous replacement. Because these devices have become the standard implant for several operative procedures, it is essential to understand their biological base. The purpose of this report is to provide a comprehensive insight into biodegradable implant biology for a better understanding of the advantages and risks associated with using these implants in the field of operative sports medicine. In particular, in vivo degradation, biocompatibility, and the osseous replacement of the implants are discussed. A standardized classification system to document and treat possible adverse tissue reactions is given, with special regard to extra-articular and intra-articular soft-tissue response and to osteolytic lesions.