In orthopaedics, meaningful innovation often arrives incrementally — but its impact is lasting. Scientific understanding evolves continuously, as do the clinical needs of patients.
Consider foot-related pathologies. These have affected humans throughout history, yet until the late 19th and early 20th centuries — with the advent of modern medicine — there were no structured medical solutions. It was only through the study of lower limb biomechanics that the first orthoses were developed, paving the way for surgical techniques in use today.
Two Decades of Progress: LSM-Med and Resorbable Devices
For the past 20 years, LSM-Med has focused on an innovative approach in this field: resorbable medical devices.
The concept is straightforward yet transformative — devices that, once implanted, naturally degrade within the body over time. Their function is fulfilled without the need for secondary surgery to remove them.
This approach addresses a key issue in traditional orthopaedic surgery. Metal implants such as titanium screws and spacers often require removal once healing is complete, as their prolonged presence can interfere with bone development and introduce risks of fragmentation or mechanical failure. In contrast, resorbable devices offer a definitive solution to a clinical problem while avoiding the stress, cost, and risk associated with additional surgical procedures.
Our Composition: PLLA and PLDLLA
All resorbable implants must rely on biocompatible materials capable of predictable degradation. LSM-Med uses two specific polymers: PLLA (poly-L-lactic acid) and PLDLLA (poly-D,L-lactic acid).
Both are derived from lactic acid, itself obtained through the fermentation of carbohydrates found in common foods such as fruits and vegetables. These processed forms of PLA are highly functional bioplastics, used extensively in medical applications for their safety and versatility.
At a molecular level, the two materials differ in structure:
- PLLA has a higher degree of crystallinity, offering superior mechanical strength and a slower degradation profile.
- PLDLLA is more amorphous, with reduced mechanical strength but a faster resorption timeline.
These polymers are shaped into final implant forms via injection moulding, performed under strict contamination control (ISO 8 Clean Room). PLA granules are melted, injected into moulds, and cooled to form the required geometry.
The Science Behind Resorption
Lactic acid — the key component of these polymers — is a molecule naturally present in human tissue and blood, especially after anaerobic activity. As the implant degrades, its by-products (CO₂, water, and lactic acid) are safely metabolised and excreted by the body through urine and respiration.
Resorption occurs both externally and internally within the implant. Water molecules penetrate the polymer, breaking down molecular chains. At the same time, the body’s immune response accelerates the process, releasing enzymes that assist in dissolving the material.
Generally, PLLA-based implants, such as the RSB Calcaneo Stop, begin degrading around 18 months post-implantation and may take up to 5–6 years to fully resorb. PLDLLA-based devices, such as cambers and pins, degrade more quickly — often within 2 to 4 years.
Tailored Applications: LSM-Med’s Resorbable Range
LSM-Med has developed a comprehensive portfolio of resorbable implants for foot surgery, designed to align with a range of clinical needs.
RSB Calcaneo Stop (PLLA)
A resorbable alternative to traditional titanium screws, this device is designed for the treatment of flatfoot, particularly in paediatric cases. Inserted into the calcaneus, it prevents outward hindfoot rotation, helping restore the natural curvature of the plantar vault. Once its function is complete, the implant gradually resorbs, avoiding interference with bone development and eliminating the need for removal surgery.
SG Metatarsal Spacer (PLLA)
Used in various metatarsophalangeal joint pathologies — including hallux rigidus, post-traumatic arthritis, and rheumatic arthropathies — this spacer provides temporary structural support during recovery, then degrades naturally over time.
RSB Implants (PLDLLA)
This category includes headless screws, toothed cambers, and pins of varying sizes, intended for general surgical use where resorbable support is preferred. These devices offer versatility across multiple procedures, with faster degradation profiles suited to short-to-medium-term stabilisation.
A Clear Step Forward in Foot Surgery
Resorbable implants represent a significant step forward in orthopaedic surgery — particularly in the treatment of foot pathologies where long-term outcomes and patient wellbeing are closely linked.
By removing the need for secondary surgery, reducing the risk of complications, and supporting natural bone development, resorbable devices offer both clinical and practical advantages. And after two decades of ongoing research, development, and surgical collaboration, LSM-Med remains committed to refining and expanding this technology.
The goal is simple: to provide surgeons with reliable tools that adapt to the body — and then quietly disappear when no longer needed.
