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      Synthetic biodegradable polymers as orthopedic devices

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      Biomaterials

      Elsevier BV

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          Abstract

          Polymer scientists, working closely with those in the device and medical fields, have made tremendous advances over the past 30 years in the use of synthetic materials in the body. In this article we will focus on properties of biodegradable polymers which make them ideally suited for orthopedic applications where a permanent implant is not desired. The materials with the greatest history of use are the poly(lactides) and poly(glycolides), and these will be covered in specific detail. The chemistry of the polymers, including synthesis and degradation, the tailoring of properties by proper synthetic controls such as copolymer composition, special requirements for processing and handling, and mechanisms of biodegradation will be covered. An overview of biocompatibility and approved devices of particular interest in orthopedics are also covered.

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          Most cited references 18

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          Biodegradable polymers for use in surgery—polyglycolic/poly(actic acid) homo- and copolymers: 1

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            Degradation rates of oral resorbable implants (polylactates and polyglycolates): rate modification with changes in PLA/PGA copolymer ratios.

            This study determined the difference in rate of degradation between pure polymers of lactic acid (pla), glycolic acid (PGA), and various ratios of copolymers of these two substances. Fast-cured and slow-cured polyglycolide was compared with copolymers of glycolide/lactide intermixed in ratios of 75:25, 50:50, and 25:75, as well as pure polylactide. A total of 420 rats were implanted with carbon-14 and tritium-labeled polymers in bone and soft tissue. At intervals of 1, 2, 3, 5, 7, 9, and 11 months, groups of five animals with the implants in bone and five with the implants in the abdominal wall were sacrificed. The implant area as well as tissue from the liver, spleen, kidney, lung and some muscle tissue was analyzed for radioactivity along with the urine and feces collected throughout the experiment. Half-lives of the different polymers and copolymers were calculated from the radioactivity present in the implant area for each time interval. Half-life of the polymers and copolymers decreased from 5 months for 100% PGA to 1 week with 50:50 PGA:PLA copolymer and rapidly increased to 6.1 months for 100% PLA. Fast-cured PGA had a half-life in tissue of 0.85 months. No difference in rate of degradation was seen in soft tissue or bone. No significant radioactivity was detected in urine, feces, or tissue samples. From this study, it is concluded that control of degradation rate of the implant could best be attained by varying the composition of PLA and PGA between 75% and 100% PLA along with a corresponding 25% to 0% PGA. This would provide a half-life range of the implant of from 2 weeks to 6 months.
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              Recombinant human bone morphogenetic protein induces bone formation.

              We have purified and characterized active recombinant human bone morphogenetic protein (BMP) 2A. Implantation of the recombinant protein in rats showed that a single BMP can induce bone formation in vivo. A dose-response and time-course study using the rat ectopic bone formation assay revealed that implantation of 0.5-115 micrograms of partially purified recombinant human BMP-2A resulted in cartilage by day 7 and bone formation by day 14. The time at which bone formation occurred was dependent on the amount of BMP-2A implanted; at high doses bone formation could be observed at 5 days. The cartilage- and bone-inductive activity of the recombinant BMP-2A is histologically indistinguishable from that of bone extracts. Thus, recombinant BMP-2A has therapeutic potential to promote de novo bone formation in humans.
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                Author and article information

                Journal
                Biomaterials
                Biomaterials
                Elsevier BV
                01429612
                December 2000
                December 2000
                : 21
                : 23
                : 2335-2346
                Article
                10.1016/S0142-9612(00)00101-0
                11055281
                © 2000

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