This Review compiles the synthesis, physical properties, and biomedical applications for the polyesters based on castor oil and ricinoleic acid. Castor oil has been known for its medicinal value since ancient times. It contains ∼90% ricinoleic acid, which enables direct chemical transformation into polyesters without interference of other fatty acids. The presence of ricinoleic acid (hydroxyl containing fatty acid) enables synthesis of various polyester/anhydrides. In addition, castor oil contains a cis-double bond that can be hydrogenated, oxidized, halogenated, and polymerized. Castor oil is obtained pure in large quantities from natural sources; it is safe and biocompatible.

The use of biodegradable materials is gaining popularity in medicine, especially in orthopedic applications. However, preclinical evaluation of biodegradable materials can be challenging, since they are located in close contact with host tissues and might be implanted for a long period of time. Evaluation of these compounds requires biodegradability and biocompatibility studies and meticulous pathology examination. We describe 2 preclinical studies performed on Sprague-Dawley rats for 52 weeks, to evaluate clinical pathology, biocompatibility, biodegradability, and systemic toxicity after implantation of 2-layered films or saline-inflated balloon-shaped implants of downsized InSpace™ devices (termed ''test device''). The test devices are made from a copolymer of poly-L-lactide-co-e-caprolactone in a 70:30 ratio, identical to the device used in humans, intended for the treatment of rotator cuff tears. Intra-articular film implantation and subcutaneous implantation of the downsized device showed favorable local and systemic tolerability. Although the implanted materials have no inherent toxic or tumorigenic properties, one animal developed a fibrosarcoma at the implantation site, an event that is associated with a rodent-predilection response where solid materials cause mesenchymal neoplasms. This effect is discussed in the context of biodegradable materials along with a detailed description of expected pathology for biodegradable materials in long-term rodent studies.

Soft tissue filler products have become very popular in recent years, with ever-increasing medical and aesthetic indications. While generally considered safe, the number of reported complications with tissue fillers is growing. Nevertheless, there is no specific animal model that is considered as the gold standard for assessing safety or efficacy of tissue fillers, and there are very little data on interspecies differences in reaction to these products. Here, we report on interspecies differences in reaction to a subcutaneous injectable co-polyester, composed of castor oil and citric acid. Comparison of the histopathological local tissue changes following 1-month postimplantation, indicated that in rats the reaction consisted of cavities, surrounded by relatively thin fibrotic enveloping capsule. In contrast, an unexpected severe inflammatory granulomatous reaction was noticed in Sinclair minipigs. To our knowledge, this is the first report on significant interspecies differences in sensitivity to tissue fillers. It emphasizes the importance of using the appropriate animal model for performing preclinical biocompatibility assays for biodegradable polymers, tissue fillers, and implanted medical devices in general. It also makes the Sinclair minipig subject for scrutiny as an animal model in future biocompatibility studies.

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Biodegradable soft tissue biopsy clips have been developed as implants with the potential to serve as visual markers for regions suspected to contain tumor growth in the breast. These clips are multidimensional tissue markers with better biocompatibility and imaging features. The clips were prepared using biodegradable polymers, poly(L-lactide-co-ε-caprolactone) and methoxy polyethylene glycol-co-L-lactide, that contain iodixanol or barium sulfate as contrast agents; they are further coated with hyaluronic acid or sodium alginate hydrogels. The clips were visible by imaging modalities such as mammography, ultrasound, and magnetic resonance imaging after implantation in Sprague− Dawley rats. The clips stayed intact in the implantation cavity of the animal for more than 3 months with unpretentious changes in their lengths and morphology. The histopathological examination of implanted clips revealed no signs of systemic toxicity in the rats. Overall, the interpretation of the results reveals that the developed clips can be a potential replacement for metal-based markers.