Interposition and augmentation devices for tendon and ligament repair,
including rotator cuff repair, have been developed as well as methods for
their delivery using arthroscopic methods. The devices are preferably
derived from biocompatible polyhydroxyalkanoates, and preferably from
copolymers or homopolymers of 4-hydroxybutyrate. The devices may be
delivered arthroscipiclly, and offer additional benefits such as support
for the surgical repair, high initial strength, prolonged strength
retention in vivo, flexibility, anti-adhesion properties, improved
biocompatibility, an ability to remodel in vivo to healthy tissue,
minimal risk for disease transmission or to potentiate infection, options
for fixation including sufficiently high strength to prevent suture pull
out or other detachment of the implanted device, eventual absorption
eliminating future risk of foreign body reactions or interference with
subsequent procedures, competitive cost, and long-term mechanical
stability. The device are also particularly suitable for use in pediatric
populations where their eventual absorption should not hinder growth.