Biocomposite Implants Composed of Poly(Lactide-co-Glycolide)/β-Tricalcium Phosphate: Systematic Review of Imaging, Complication, and Performance Outcomes

Abstract

Purpose: To determine the degradation and performance outcomes of poly(lactide-co-glycolide)/β-tricalcium phosphate (PLGA/β-TCP) implants.

Methods: A MEDLINE and Embase search for randomized or nonrandomized controlled studies and prospective or retrospective case series that used biocomposite interference screws or suture anchors composed of PLGA/β-TCP was performed. Main outcomes included volume of implant resorption and incidence of osteoconductivity at implant sites, imaging findings, adverse events, and the frequency of reoperations.

Results: A total of 13 studies representing 668 patients with either knee or shoulder implants were included. Median follow-up was 28 months (range: 12-37 months). Biocomposite implants lost 88% of their original volume during follow-up. Osteoconductivity at the implant site was identified in 63% of cases. Adverse events included tunnel widening (3%), effusion (5%), and cyst formation (4%). Synovitis was not reported.

Conclusions: Biocomposite interference screws or suture anchors composed of PLGA/β-TCP almost fully absorb over 3 years while promoting osteoconductivity with few reported adverse events.

Level of evidence: Level IV, systematic review of Level I-IV studies.