How do Polymer-derived Implants Influence Patient-Reported Outcomes (PRO) in Cardiovascular and Orthopaedic Procedures

Year : 2026 | Volume : 14 | Special Issue 01 | Page : 1821 1834
    By

    Anisha Biswas,

  • Poulami Manna,

  • Hema Santra Manna,

  • Ankita Jana,

  • Arunika Bhadra,

  • Indrajit Ghosal,

  1. Assistant Professor, Department of Hospital Management, Brainware University, West Bengal, India
  2. Assistant Professor, Department of Hospital Management, Institute of Advance Education and Research, West Bengal, India
  3. Assistant Professor, Department of Hospital Management, Institute of Advance Education and Research, West Bengal, India
  4. Assistant Professor, Department of Hospital Management, Runax Institute, West Bengal, India
  5. Assistant Professor, Department of Hospital Management, Brainware University, West Bengal, India
  6. Associate Professor, Department of Management, Brainware University, West Bengal, India

Abstract

Implants derived from polymers have surfaced as adaptable substitutes for conventional metallic devices in cardiovascular and orthopedic treatments because of their adjustable mechanical characteristics, biocompatibility, radiolucency, and ability for surface alteration. This systematic review assesses the impact of polymer-based implants such as PEEK, UHMWPE, bioresorbable polymer scaffolds, and drug-eluting systems on outcomes reported by patients (PROs). Findings from 42 qualifying studies show overall positive impacts on pain alleviation, functional recovery, health-related quality of life (HRQoL), and patient satisfaction. In orthopaedics, materials like PEEK spinal cages and highly cross-linked UHMWPE liners consistently show enhancements in mobility, comfort, and long-term performance by decreasing wear, osteolysis, and revision rates. Cardiovascular polymer implants, especially drug-eluting bioresorbable scaffolds, demonstrate early symptom relief and enhancements in HRQoL, as PROMs indicate better angina stability and improvements in physical function. Nonetheless, late complications such as scaffold thrombosis have resulted in inconsistent long-term results when compared to durable polymer metallic stents. PROM mapping identifies widely utilized instruments, including WOMAC, KOOS, VAS, SAQ, and KCCQ, reflecting diverse patient experiences; nonetheless, variations in reporting and inconsistency restrict comparisons across studies. In general, polymer implants show PRO benefits compared to metals in specific cases, bolstered by superior imaging compatibility, decreased stiffness, improved comfort, and fewer wear-related issues. However, disparities remain concerning long-term cardiovascular PRO data, the standardization of implant-specific PROMs, and the alignment of devices with patients. Subsequent studies ought to focus on longitudinal tracking of PROs and comparative trials to enhance personalized implant choices and improve patient-centered care.

Keywords: polymer implants, patient-reported outcomes, orthopaedic implants, cardiovascular devices, PEEK/UHMWPE.

[This article belongs to Special Issue under section in Journal of Polymer & Composites (jopc)]

How to cite this article:
Anisha Biswas, Poulami Manna, Hema Santra Manna, Ankita Jana, Arunika Bhadra, Indrajit Ghosal. How do Polymer-derived Implants Influence Patient-Reported Outcomes (PRO) in Cardiovascular and Orthopaedic Procedures. Journal of Polymer & Composites. 2026; 14(01):1821-1834.
How to cite this URL:
Anisha Biswas, Poulami Manna, Hema Santra Manna, Ankita Jana, Arunika Bhadra, Indrajit Ghosal. How do Polymer-derived Implants Influence Patient-Reported Outcomes (PRO) in Cardiovascular and Orthopaedic Procedures. Journal of Polymer & Composites. 2026; 14(01):1821-1834. Available from: https://journals.stmjournals.com/jopc/article=2026/view=239809


References

  1. Rane, A. V., Abitha, V. K., Sisanth, K. S., & Kanny, K. (2024). Introduction to polymer materials for implants. In Polymeric Materials for Biomedical Implants(pp. 1-29). Woodhead Publishing.
  2. Balakrishnan, B., Hassan, P. A., & Tyagi, A. K. (2024). An introduction to biomaterials. In Engineered Biomaterials: Progress and Prospects(pp. 1-57).
  3. Jaramillo, S., de Pontes, V. B., Pinilla, J. A., Stabile, F., Felix, N., Clemente, M. R., & Garot, P. (2025). Comparative efficacy and safety of latest generation ultrathin and thin biodegradable polymer vs. durable polymer drug-eluting stents in small vessel coronary artery disease: A systematic review and meta-analysis. Cardiovascular Revascularization Medicine.
  4. Rehman, A., Ahmed, I. E., Nouman, A., Irfan, R., Rehman, Q., Syed, A. R. S., … & Varrassi, G. (2024). Comparison of long-term clinical outcomes of bioabsorbable polymer versus durable polymer drug-eluting stents: a systematic review and meta-analysis. The Egyptian Heart Journal, 76(1), 91.
  5. Kumar, V., Tewari, R. P., & Rawat, A. (2024). Tribological evolution of ultra-high molecular weight polyethylene and its composites for hip and knee replacement implants: A. Jurnal Tribologi, 42, 161-197.
  6. Kannan, B., Marimuthu, U., & Shankar, B. (2025). Advancements and challenges in UHMWPE biomaterial implants: a comprehensive analysis of reinforcement and coating strategies. International Journal of Polymeric Materials and Polymeric Biomaterials, 1-16.
  7. Gasior, P., Gierlotka, M., Szczurek-Katanski, K., Osuch, M., Roleder, M., Hawranek, M., … & Polonski, L. (2021). Biodegradable polymer-coated thin strut sirolimus–eluting stent versus durable polymer-coated everolimus-eluting stent in the diabetic population. Cardiology Journal, 28(2), 235-243.
  8. Abouelenien, M. M., Tanas, Y., Mekky, M. E., Elgendy, R., Zidan, A., & Motawea, K. R. (2025). Long‐Term Safety and Efficacy of Ultrathin Bioabsorbable‐Polymer Sirolimus‐Eluting Stents Versus Thin Durable‐Polymer Everolimus‐Eluting Stents in Patients Undergoing Percutaneous Coronary Intervention: A Systematic Review and Meta‐Analysis. Catheterization and Cardiovascular Interventions.
  9. Mbogori, M., Vaish, A., Vaishya, R., Haleem, A., & Javaid, M. (2022). Poly-Ether-Ether-Ketone (PEEK) in orthopaedic practice-A current concept review. Journal of Orthopaedic Reports, 1(1), 3-7.
  10. S. Food and Drug Administration (FDA). (2009). Guidance for Industry: Patient-Reported Outcome Measures — Use in Medical Product Development to Support Labeling Claims. (Use for PRO methodology justification).
  11. Alqutaibi, A. Y., Alghauli, M. A., Algabri, R. S., Hamadallah, H. H., Aboalrejal, A. N., Zafar, M. S., & Fareed, M. A. (2025). Applications, modifications, and manufacturing of polyetheretherketone (PEEK) in dental implantology: A comprehensive critical review. International Materials Reviews, 70(2), 103-136.
  12. VijayKashimatt, M. G. (2024). A systematic review of the process parameters, mechanical characteristics and applications of polyether ether ketone (PEEK) and its composites by additive manufacturing. Engineering Research Express, 6(3), 032502.
  13. Wei, Z., Zhang, Z., Zhu, W., & Weng, X. (2023). Polyetheretherketone development in bone tissue engineering and orthopedic surgery. Frontiers in bioengineering and biotechnology, 11, 1207277.
  14. Chen, T., Lu, D., Wang, S., Yang, H., Fan, W., Xiao, Z., … & Cheng, L. (2025). Advanced hydrogel therapeutics for intervertebral disc degeneration: Engineering structural–functional properties in natural and synthetic biomaterials. Bioengineering & Translational Medicine, e70059.
  15. Das, S. S., Sharma, D., Rao, B. V. K., Arora, M. K., Ruokolainen, J., Dhanka, M., … & Kesari, K. K. (2023). Natural cationic polymer-derived injectable hydrogels for targeted chemotherapy. Materials Advances, 4(23), 6064-6091.
  16. Han, C., Zhang, L., Bao, R., Lu, Y., Dong, X., Zhang, T., … & Liu, S. (2025). Biodegradable metabotissugenic citrate-based polymer derived self-sealing pro-regenerative membrane for tendon anti-biofouling and repair. Bioactive Materials, 51, 598-612.
  17. Lesko, L., Jungova, P., Culenova, M., Thurzo, A., & Danisovic, L. (2025). Polymer-Based Scaffolds as an Implantable Material in Regenerative Dentistry: A Review. Journal of Functional Biomaterials, 16(3), 80.
  18. Toong, D. W. Y., Toh, H. W., Ng, J. C. K., Wong, P. E. H., Leo, H. L., Venkatraman, S., … & Huang, Y. (2020). Bioresorbable polymeric scaffold in cardiovascular applications. International journal of molecular sciences, 21(10), 3444.
  19. Ayton, D. R., Barker, A. L., Peeters, G. M., Berkovic, D. E., Lefkovits, J., Brennan, A., … & McNeil, J. (2018). Exploring patient‐reported outcomes following percutaneous coronary intervention: A qualitative study. Health Expectations, 21(2), 457-465.
  20. Gao, R., Yang, Y., Han, Y., Huo, Y., Chen, J., Yu, B., … & ABSORB China Investigators. (2015). Bioresorbable vascular scaffolds versus metallic stents in patients with coronary artery disease: ABSORB China trial. Journal of the American College of Cardiology, 66(21), 2298-2309.
  21. Power, D. A., Camaj, A., Kereiakes, D. J., Ellis, S. G., Gao, R., Kimura, T., … & ABSORB Investigators. (2025). Early and late outcomes with the Absorb bioresorbable vascular scaffold: final report from the ABSORB clinical trial program. Cardiovascular Interventions, 18(1), 1-11.
  22. Power, D. A., Camaj, A., Kereiakes, D. J., Ellis, S. G., Gao, R., Kimura, T., … & ABSORB Investigators. (2025). Early and late outcomes with the Absorb bioresorbable vascular scaffold: final report from the ABSORB clinical trial program. Cardiovascular Interventions, 18(1), 1-11.
  23. Chaus, A., & Uretsky, B. F. (2023). Bioresorbable vascular scaffolds: a dissolving dream?. Cardiovascular Drugs and Therapy, 37(1), 1-3.
  24. Vanoverbeke, L., & Bennett, J. (2025). Drug-eluting resorbable coronary scaffolds: a review of recent advances. Expert Opinion on Drug Delivery, 1-15.
  25. Al-Shalawi, F. D., Hanim, M. A., Ariffin, M. K. A., Kim, C. L. S., Brabazon, D., Calin, R., & Al-Osaimi, M. O. (2023). Biodegradable synthetic polymer in orthopaedic application: A review. Materials Today: Proceedings, 74, 540-546.
  26. Al-Shalawi, F. D., Mohamed Ariff, A. H., Jung, D. W., Mohd Ariffin, M. K. A., Seng Kim, C. L., Brabazon, D., & Al-Osaimi, M. O. (2023). Biomaterials as implants in the orthopedic field for regenerative medicine: metal versus synthetic polymers. Polymers, 15(12), 2601.
  27. Atif, M., Shoukat, S., Imran, M., & Alex, M. (2025). Paradigm shift in orthopedic implants from metals to polymers. Iranian Polymer Journal, 34(8), 1261-1284.
  28. Kruse, H. V., Chakraborty, S., Chen, R., Kumar, N., Yasir, M., Lewin, W. T., … & McKenzie, D. R. (2024). Protecting orthopaedic implants from infection: Antimicrobial peptide Mel4 Is non-toxic to bone cells and reduces bacterial colonisation when bound to plasma Ion-implanted 3D-printed PAEK polymers. Cells, 13(8), 656.
  29. Moreno, L., Mohedano, M., Arrabal, R., Rodriguez-Hernandez, J., & Matykina, E. (2023). Development of hybrid hierarchical coatings on Mg3Zn0. 4Ca alloy for orthopaedic implants. Journal of Materials Research and Technology, 24, 5823-5838.
  30. Li, W., Zhao, H., Li, C., Liu, T., Guan, J., Yang, Y., & Yu, X. (2023). Polyetheretherketone (PEEK) rods versus titanium rods for posterior lumbar fusion surgery: a systematic review and meta-analysis. Journal of Orthopaedic Surgery and Research, 18(1), 348.
  31. Bergvinsson, H., Zampelis, V., Sundberg, M., & Flivik, G. (2021). Highly cross-linked polyethylene still outperforms conventional polyethylene in THA: 10-year RSA results. Acta Orthopaedica, 92(5), 568-574.
  32. Pighi, M., Tomai, F., Fezzi, S., Pesarini, G., Petrolini, A., Spedicato, L., … & Ribichini, F. (2024). Safety and efficacy of everolimus-eluting bioresorbable vascular scaffold for cardiac allograft vasculopathy (CART). Clinical Research in Cardiology, 113(7), 1017-1029.
  33. Sarfraz, S., Mäntynen, P. H., Laurila, M., Rossi, S., Leikola, J., Kaakinen, M., … & Reunanen, J. (2022). Comparison of titanium and PEEK medical plastic implant materials for their bacterial biofilm formation properties. Polymers, 14(18), 3862.
  34. Karuppiah, G., Kuttalam, K. C., Palaniappan, M., Santulli, C., & Palanisamy, S. (2020). Multiobjective optimization of fabrication parameters of jute fiber/polyester composites with egg shell powder and nanoclay filler. Molecules, 25(23), 5579.
  35. Padmanabhan, R. G., Rajesh, S., Karthikeyan, S., Palanisamy, S., Ilyas, R. A., Ayrilmis, N., … & Kchaou, M. (2024). Evaluation of mechanical properties and Fick’s diffusion behaviour of aluminum-DMEM reinforced with hemp/bamboo/basalt woven fiber metal laminates (WFML) under different stacking sequences. Ain Shams Engineering Journal, 15(7), 102759.
  36. Ayrilmis, N., Kanat, G., Yildiz Avsar, E., Palanisamy, S., & Ashori, A. (2025). Utilizing waste manhole covers and fibreboard as reinforcing fillers for thermoplastic composites. Journal of Reinforced Plastics and Composites, 44(17-18), 1108-1118.
  37. Ramasubbu, R., Kayambu, A., Palanisamy, S., & Ayrilmis, N. (2024). Mechanical Properties of Epoxy Composites Reinforced with Areca catechu Fibers Containing Silicon Carbide. BioResources, 19(2).
  38. Aruchamy, K., Karuppusamy, M., Krishnakumar, S., Palanisamy, S., Jayamani, M., Sureshkumar, K., … & Al-Farraj, S. A. (2025). Enhancement of Mechanical Properties of Hybrid Polymer Composites Using Palmyra Palm and Coconut Sheath Fibers: The Role of Tamarind Shell Powder. BioResources, 20(1).
  39. Kar, A., Saikia, D., Palanisamy, S., & Pandiarajan, N. (2025). Effect of fiber loading on the mechanical, morphological, and dynamic mechanical characteristics of Calamus tenuis fiber reinforced epoxy composites. Journal of Vinyl and Additive Technology, 31(1), 224-240.

Special Issue Subscription Original Research
Volume 14
Special Issue 01
Received 11/11/2025
Accepted 22/11/2025
Published 11/03/2026
Publication Time 120 Days


Login


My IP

PlumX Metrics