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Design of biodegradable, implantable devices towards clinical translation

Nature Reviews Materials volume 5, pages 61–81 (2020)Cite this article

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Abstract

Biodegradable materials, including natural and synthetic polymers and hydrolyzable metals, constitute the main components of temporary, implantable medical devices. Besides the intrinsic properties of the materials, the most critical factor determining the successful clinical outcome of implantable and degradable devices is the host response, particularly the immune response, which largely depends on the material features and degradation mechanisms. In this Review, we first survey the state of the art in terms of materials options for use in biodegradable medical devices, focusing on degradation mechanisms and their control. In particular, we highlight silk, which is emerging as an important polymer, owing to its mechanical robustness, bioactive component sequestration, degradability without problematic metabolic products and biocompatibility. We then discuss the host response to these biodegradable materials in terms of dynamic tissue–implant interfaces. Next, we examine the clinical translation of three leading biodegradable material systems — natural and synthetic biodegradable polymers and biodegradable metals — and the related challenges in the context of orthopaedic fixation devices, cardiovascular stents and biodegradable electronic devices. Looking to the future, we propose updated material design strategies to improve the clinical outcomes for these biodegradable medical devices.

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Fig. 1: Host response to implanted materials and devices.
Fig. 2: Schematic overview of in vivo biodegradation of various materials.
Fig. 3: 3D silk materials for the fabrication of orthopaedic fixation devices.
Fig. 4: Biodegradable electronic devices.
Fig. 5: Design of biodegradable medical devices.

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Acknowledgements

We thank the NIH (R01AR068048, 5P41EB002520) and Stepping Strong Foundation, Brigham and Women's Hospital (A.N.) for support of this work. We also thank our many past students who have contributed to some of the foundations discussed here, as well as our many collaborators over the years.

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  1. These authors contributed equally: Chunmei Li, Chengchen Guo

Authors and Affiliations

  1. Department of Biomedical Engineering, Tufts University, Medford, MA, USA

    Chunmei Li, Chengchen Guo, Vincent Fitzpatrick & David L. Kaplan

  2. Divisions of Plastic Surgery and Otolaryngology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA

    Ahmed Ibrahim, Myrthe Jasmijn Zwierstra & Samuel J. Lin

  3. Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA

    Philip Hanna, Aron Lechtig & Ara Nazarian

  4. Department of Orthopaedic Surgery, Yerevan State Medical University, Yerevan, Armenia

    Ara Nazarian

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C.L., C.G., V.F. and D.K. wrote the manuscript. All authors made substantial contributions to the discussion of the content and reviewed and edited the manuscript before submission.

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Li, C., Guo, C., Fitzpatrick, V. et al. Design of biodegradable, implantable devices towards clinical translation. Nat Rev Mater 5, 61–81 (2020). https://doi.org/10.1038/s41578-019-0150-z

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