Advantages and Challenges of Biodegradable Implants

Orthopedic and oral/maxillofacial implants currently represent a combined $2.8 billion market, a figure expected to experience significant and continued growth. Although traditional permanent implants have proven clinically efficacious, they are also associated with several drawbacks, including secondary surgeries, infection, and rejection.

What is a biodegradable implant?

A biodegradable implant is a medical device made of synthetic material designed to be more naturally accepted by the body’s systems and to slowly dissolve or break down within the body over time. Unlike traditional implants that require surgical removal, biodegradable implants are non-permanent, offering several advantages, including reduced risk of complications, improved patient comfort, and potential cost savings as they eliminate the need for secondary or follow-up procedures.

Biodegradable Implants – Emerging Technologies

The field of biodegradable implants is evolving with several promising technologies. 

• 3D printing allows for highly customized implants that precisely match the patient’s anatomy, improving fit and function. Biodegradable materials can be printed into intricate shapes and structures that are difficult or impossible to achieve with traditional manufacturing methods. Using high-resolution imaging and computer modeling, doctors can design a custom implant that perfectly matches the patient's bone structure and joint mechanics.
• Smart Implants incorporate sensors into biodegradable structures, providing real-time information about the implant’s degradation and tissue response. Smart implants can even be designed to adapt their properties or release drugs in response to changes in the body’s environment.
• Bioactive Coatings made from materials such as stem cells can promote tissue regeneration.  A bioactive coating can target and deliver drugs to a specific area of the body, improving efficacy and reducing side effects.
• Natural Materials such as silk, collagen, and chitosan are being explored for expanded biodegradable implant options. These materials frequently exhibit biocompatibility and can be tailored to specific applications.
• Nanotechnology can create biodegradable implants with controlled drug release profiles, ensuring optimal therapeutic effects. Nanomaterials can also be incorporated to improve mechanical strength and durability.
• Personalized Medicine advancements may include the development of biodegradable implant options based on a patient’s custom genetic makeup and medical history.

Advantages of Biodegradable Implants

Biodegradable implants offer several advantages over traditional, permanent implants. As previously mentioned, one of the most significant advantages is the elimination of the need for additional surgery to remove or adjust the implant, thereby reducing patient recovery time and long-term health costs and greatly improving patient comfort. There are also fewer risks of complications with the use of biodegradable implants, such as infection or implant rejection, due to the fact that the materials used are specifically designed to be more biocompatible. This means that the implant is less likely to provoke adverse or prolonged immune responses like inflammation. The gradual degradation of the implant also encourages better tissue integration and healing. By reducing the long-term presence of foreign material, the body is encouraged to adapt and integrate the implant more smoothly. As a result, biodegradable implants are less likely to spur the formation of excessive fibrous tissue around the implant (i.e., fibrosis), which can be seen with more permanent implants. 

Success Stories

Biodegradable implants are ideal for temporary applications, especially in situations requiring fracture fixation or targeted drug delivery. These implants have been successfully used as mechanical support during procedures involving bone healing, vascular stents to keep blood vessels open, and mechanisms for the slow release of drugs to reduce inflammation. The first successful example of biodegradable electronic medicine may be credited to a group of researchers at Northwestern University and Washington University School of Medicine in St. Louis who, in 2018, developed an implantable, biodegradable wireless device that speeds up nerve regeneration by delivering regular pulses of electricity to damages peripheral nerves. The lead researcher for the device, John Rogers, PhD, later led the development of a biodegradable pacemaker in 2021 and, most recently, an implantable, biodegradable pain management device in 2022. 

Challenges and Limitations

Despite their impressive advantages, biodegradable implants also present some challenges and limitations. One of the main struggles is controlling the degradation rate while maintaining the implant’s structure and integrity. Also, while implants can potentially reduce long-term healthcare costs, initial implants may have costs that are higher than traditional implant options due to the complexity of the materials and manufacturing process. Finally, obtaining regulatory approval for some biodegradable implants, especially those with complex functions like wireless devices and drug delivery mechanisms, may prove more difficult than traditional implants. 

Future Potential for a Greener Tomorrow

Biodegradable implants show great potential for the future of patient care. Continued research and innovations in material sciences will pave the way for a more sustainable and patient-centric approach, propelling the creation of sophisticated biodegradable implants. As sustainability becomes more essential, lowering the environmental burden of implant disposal is a winning combination for enhancing patient outcomes and quality of life.

Authored by Maria-Cristina Smith, Berkley Life Sciences, Vice President, Products & Professional Liability Specialist