Purpose: This systematic review examines the role of biodegradable implants in orthopaedic traumatology, focusing on their advantages, limitations, and clinical applications compared to traditional non-biodegradable implants. Key factors such as biocompatibility, mechanical performance, and degradation were evaluated to understand their impact on fracture healing and patient outcomes. Methods: A systematic search of the current literature and clinical studies between 2010 and 2024 was conducted. Comparative data between biodegradable (polymeric and metallic) and non-biodegradable metallic implants were assessed, particularly concerning clinical outcomes and patient satisfaction. The review process was conducted according to the PRISMA guidelines. Results: Forty studies were selected for analysis out of 1,366 studies. Biodegradable implants demonstrated effective mechanical support during bone healing, with gradual load transfer to the regenerating bone. They reduced the need for secondary surgeries, particularly in paediatric cases, where they mitigated growth disturbances associated with metallic implants. However, challenges such as implant-related inflammation and premature degradation were noted. Comparative studies revealed similar or superior clinical outcomes with biodegradable implants, although mechanical strength remained a concern in specific applications. Conclusion: Biodegradable implants can represent a transformative shift in orthopaedic traumatology, not only offering advantages over metallic implants but also supporting a broader conceptual evolution in fracture fixation. Future research and development of advanced materials are essential to address current limitations. Emerging technologies, such as complex alloys, the addition of reinforcements, new manufacturing techniques, and a focus on biocompatibility, bone regeneration, and functionalisation of the implant, may offer controlled biodegradation, superior biocompatibility, antimicrobial properties, and tailored mechanical performance.
Marta et al. (Mon,) studied this question.