Biomechanical and bioactivity concepts of polyetheretherketone composites for use in orthopedic implants—a review

Abstract

The use of polyetheretherketone (PEEK) composites in the trauma plating system, total replacement implants, and tissue scaffolds has found great interest among researchers. In recent years (2008 afterward), this type of composites has been examined for suitability as substitute material over stainless steel, titanium alloys, ultra high molecular weight polyethylene, or even biodegradable materials in orthopedic implant applications. Biomechanical and bioactivity concepts were contemplated for the development of PEEK orthopedic implants and a few primary clinical studies reported the clinical outcomes of PEEK-based orthopedic implants. This study aims to review and discuss the recent concepts and contribute further concepts in terms of biomechanical and bioactivity challenges for the development of PEEK and PEEK composites in orthopedic implants.

Enhanced bioactivity and osseointegration of PEEK with accelerated neutral atom beam technology

“…Most of these techniques have been met with limited in vitro success. Although PEEK or PEEK composites could provide advantageous biomechanical characteristics compared with metals, and advancement in bioactivity have been made, further studies are essential to utilize PEEK in orthopedic, dental, and trauma implants …”

“…Although many other surface modification techniques exist to enhance the bioactivation of PEEK including several physical techniques such as plasma, ion beam implantation, and extreme ultra violet; chemical techniques such as sulfonation; and numerous coating techniques (see Refs. and for recent reviews). ANAB is unique in that it has an extremely shallow penetration without causing any sub‐surface damage beyond 2 to 3 nm .…”

Incorporating Si3N4 into PEEK to Produce Antibacterial, Osteocondutive, and Radiolucent Spinal Implants

“…These shortcomings are an unfortunate consequence of a combination of its hydrophobic character and specific molecular interactions between the bacterial proteins and PEEK's surface molecular structure in the biological environment . Consequently, functionalization of PEEK to concurrently boost its osteogenic and antibacterial properties is actively being pursued in order to develop an improved generation of trauma, spinal, prosthodontic, maxillofacial, and cranial implants . The two strategies currently used to improve the bioactivity and the antimicrobial properties of PEEK are surface functionalization and composites.…”

Plasma ion implantation enabled bio-functionalization of PEEK improves osteoblastic activity

“…6 Polyether ether ketone (PEEK) is a promising candidate for the next generation of orthopedic implant materials because of its bone-like mechanical properties [7][8][9][10][11] and outstanding thermal 12 and chemical stabilities. [13][14][15][16] However, while well-tolerated in vivo, PEEK is mildly hydrophobic and bio-inert, resulting in poor surface tissue bonding, particularly in a bone apposition setting. 14,15,17 This inadequate integration between the polymer implant surface and bone tissue often leads to implant failure.…”

“…[13][14][15][16] However, while well-tolerated in vivo, PEEK is mildly hydrophobic and bio-inert, resulting in poor surface tissue bonding, particularly in a bone apposition setting. 14,15,17 This inadequate integration between the polymer implant surface and bone tissue often leads to implant failure. There is a clear need for surface modification technology that can improve the ability of PEEK to promote bone cell adhesion, growth, and associated bone formation.…”