There is no such thing as a biocompatible material

This Leading Opinion Paper discusses a very important matter concerning the use of a single word in biomaterials science. This might be considered as being solely concerned with semantics, but it has implications for the scientific rationale for biomaterials selection and the understanding of their performance. That word is the adjective ‘biocompatible’, which is often used to characterize a material property. It is argued here that biocompatibility is a perfectly acceptable term, but that it subsumes a variety of mechanisms of interaction between biomaterials and tissues or tissue components and can only be considered in the context of the characteristics of both the material and the biological host within which it placed. De facto it is a property of a system and not of a material. It follows that there can be no such thing as a biocompatible material. It is further argued that in those situations where it is considered important, or necessary, to use a descriptor of biocompatibility, as in a scientific paper, a regulatory submission or in a legal argument, the phrase ‘intrinsically biocompatible system’ would be the most appropriate. The rationale for this linguistic restraint is that far too often it has been assumed that some materials are ‘universally biocompatible’ on the basis of acceptable clinical performance in one situation, only for entirely unacceptable performance to ensue in quite different clinical circumstances.