Polymer implants in advancing age of radiation medicine

Polymer-based biomedical implants are integral to modern healthcare, having crucial role in orthopaedics, dentistry, cardiovascular surgery, and reconstructive procedures. As use of ionizing radiation is increasing in implant manufacturing, diagnostic and therapeutic clinical practices, these implants are routinely exposed to radiation environments. Low to high dose radiation exposures can initiate chemical, structural, and mechanical alterations in polymeric materials, potentially compromising their long-term functionality and biocompatibility. This review synthesizes current knowledge on the effects of ionizing radiation on biomedical polymer implants, from both industrial radiation chemistry, and biomedical material science. Clinical contexts are categorized into external beam radiotherapy, brachytherapy, internal radionuclide therapy, nuclear medicine imaging, and sterilization, with detailed dose ranges and potential material impact. A polymer-by-polymer analysis is provided, including mechanisms of radiation interaction and irradiation effects reported. Radiation effect mitigation strategies are also reviewed here. The review also identifies key future directions, including requirement of NM-compatible implant design, patient-specific implant planning using SPECT/PET-based dose mapping, in-vivo data validation, and standardized prosthesis testing protocols. Addressing these gaps through interdisciplinary research can guide the development of radiation-resilient polymer implants, ensuring safety, performance, and regulatory compliance in the new age of radiation-integrated clinical practice.