Table 5.

The most commonly used polymer-based bone substitute.

Polymer Bone-Based Material	Type	Advantages	Disadvantage	Applications
Non-biodegradable
Poly methyl methacrylate (PMMA)	Acrylic glass	Biocompatible, biologically inert durable, superior osseointegration	Non-degradable, residual monomer can enter the bloodstream and cause embolism, limited biological response, shrink during polymerization leading to free spaces between cement and prosthesis or bone, excess of tension can cause cement fractures and release of cement particles caused inflammatory reaction, exothermic polymerization	Orthopaedic prostheses fixation, craniofacial defects, dentures, vertebroplasty and kyphoplasty
Biodegradable
Poly(lactic acid) (PLA)	Aliphatic polyester.	Biodegradable, tunable physical and mechanical properties. osteoconductive, biodegradable, biocompatible, promote bone regeneration, Crystallinity tunable by changing hydroxylation degree	Acidic degradation products that might cause adverse tissue reactions, and lack of cellular adhesion due to hydrophobicity	Orthopaedic fixation tools, tendon and ligament repair, vascular stents, bone graft extender, carriers of bioactive factors. PLA, PLGA block copolymers use for drug eluting coatings
Poly(glycolic acid) (PGA)
Poly(lactic-co-glycolic acid) (PLGA)				Act as a copolymer of PLA and PGA, similar application spectrum as PLA
Poly caprolactone (PCL)		Biodegradable, Machinability, good mechanical strength, high porosity, crystallinity and thermal stability, crosslink in situ, printed by injection	Slow degradation rate, poor water wettability, lack of cell adhesion, low mechanical strength	Production of specialty polyurethanes, composite with other biomaterial to create tissue-engineered scaffolds, injectable implants for controlled release drug-delivery systems
Poly (vinyl alcohol) (PVA)	Polyalcohol	Biodegradable, tunable water solubility and crystallinity, biocompatible	Lower water solubility and crystallinity, cross-linking of polymers to maintain integrity	Used in tissue-engineering applications from the laboratory to the pre-clinical research
Poly (propylene fumarate) (PPF)	Unsaturated linear polyester	Osteoconductive, biocompatible, tunable degradation time, controllable mechanical properties, double bond along its backbone permits cross-linking in situ	Cross-linking of polymers to maintain integrity	Holds promise for use as regenerative scaffolds and bone cements often as part of an injectable bone replacement composite