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The main focus for our Biomaterials programme has been on Bioresorbable Materials. These are materials which, when implanted in the body, breakdown over time to materials that can be eliminated from the body via natural pathways leaving no evidence of the injury or repair. Perhaps the best-known use for bioresorbables is in sutures, but they are also used in a wide range of other medical implants where temporary fixation of tissue is required. Within Smith & Nephew, our Endoscopy business sells a range of suture anchors, meniscal tacks and interference screws made from bioresorbable polymers and our Orthopaedics business sells bioresorbable bone graft substitute materials. 

Bioresorbable products offer a number of advantages over their non-resorbable counterparts, for example, they:

• Are eliminated from the body and replaced by host tissue
• Eliminate the need for a second surgical procedure to remove the implant
• Allow transfer of loads to healing bone
• Avoid complications that can occur with some metal implants – e.g. stress shielding, corrosion, release of metal ions
• Are compatible with MRI imaging
• Mean revision surgery is not complicated by presence of an implant
• Can be used to deliver bioactive agents etc.

The use of bioresorbable materials in medical devices is therefore growing rapidly and they represent a great opportunity for Smith & Nephew.

The Enabling Technologies programme has identified a number of opportunities to develop improved bioresorbable materials for the future. These include:

• Better control of degradation rates
• High strength materials
• Improved biocompatibility and long term in-vivo response
  

Our programme is actively developing novel, patented solutions to address these opportunities for new materials. In the longer term, we also want to go beyond this and to start to develop "interactive" biomaterials which are not only more biocompatible but which actively enhance the speed and/or quality of tissue repair.

The aim of the Cell Based Therapies Programme is to develop treatments that restore tissues when the body's own repair systems are inadequate or absent. Major target applications are:

 - Articular cartilage
 - Bone restoration

Our definition for Cell based therapies is:

'Therapies incorporating viable or non-viable cells for replacement of defective tissue and stimulation of regeneration.'

The research programme aims to develop therapies to address major unmet clinical needs for regeneration of tissues bone and cartilage. For example, defects in the articular cartilage (present in knee and hip joints) are incapable of natural restoration and there is currently no fully effective therapy for the durable correction of this debilitating condition. Left untreated, the joint progressively degenerates and ultimately patients may require total joint replacement. One of our key aims is to be able intervene at an earlier stage and stop the degenerative processes.

A major part of our research is concentrated on Adult Stem Cells, which are immature versions of normal cells and can be encouraged to differentiate into different forms of tissue. These cells have the potential to provide effective biological solutions to resolve debilitating conditions in Orthopaedic Tissues. Much of the basic biology for these cells is now established and our research is now addressing the substantial technical, clinical and commercial challenges that need to be overcome so that these therapies can be made available in the clinic. We are looking at how Smith Nephew can use the patient's own stem cells to stimulate repair as well as using banks of donated cells. Smith & Nephew does not carry out research using embryonic stem cells.