Stereoregular bioresorbable polyesters for orthopaedic surgery

Abstract

The feasability of using poly(α-hydroxy-acid)s (poly-(glycolic acid), poly(L-lactic acid), L and D-lactic acid stereocopolymers and copolymers of glycolic and L- and D-lactic acids) for processing bioresorbable bone plates, screws, nails etc..., is questioned in regard to the requirements for effective applications and to the data reported in the open literature. Experiments carried out on home-made samples confirm the biocompatibility of these polyesters and the fast resorption of the amorphous compounds. In contrast, our results concerning crystalline poly(L-lactic acid) disagree with those of the literature. The discrepancies might result from differences in the basic material, differences in crystallinity and/or degradation of macromolecules which has been shown to occur sometimes during the elaboration of ready-for-implantation samples. Indeed, quasi-biostable bone plates based on isotactic poly(L-lactic acid) have been obtained according to an elaboration process which preserves the integrity of the synthesized macromolecules. The effects of enantiomeric purity and of implantation time on the tensile strength are reported for a series of welldefined stereocopolymers. Current studies show that highly isotactic poly(lactic acid)s (L/L+D > 92%) are polymers of particular interest for effective applications in bone surgery, especially for the construction of completely resorbable composite devices whose reinforcement consists of poly(glycolic acid) fibers.