Polyether ether ketone implants achieve increased bone fusion when coated with nano-sized hydroxyapatite: a histomorphometric study in rabbit bone

Abstract

Polyether ether ketone (PEEK) possesses excellent mechanical properties similar to those of human bone and is considered the best alternative material other than titanium for orthopedic spine and trauma implants. However, the deficient osteogenic properties and the bioinertness of PEEK limit its fields of application. The aim of this study was to limit these drawbacks by coating the surface of PEEK with nano-scaled hydroxyapatite (HA) minerals. In the study, the biological response to PEEK, with and without HA coating, was investigated. Twenty-four screw-like and apically perforated implants in the rabbit femur were histologically evaluated at 3 weeks and 12 weeks after surgery. Twelve of the 24 implants were HA coated (test), and the remaining 12 served as uncoated PEEK controls. At 3 weeks and 12 weeks, the mean bone–implant contact was higher for test compared to control ( P <0.05). The bone area inside the threads was comparable in the two groups, but the perforating hole showed more bone area for the HA-coated implants at both healing points ( P <0.01). With these results, we conclude that nano-sized HA coating on PEEK implants significantly improved the osteogenic properties, and in a clinical situation this material composition may serve as an implant where a rapid bone fusion is essential.

Biomechanical, histological, and computed X‐ray tomographic analyses of hydroxyapatite coated PEEK implants in an extended healing model in rabbit

“…[26][27][28] The results were convincing and revealed a significantly higher degree of osseointegration for coated implants compared to neat PEEK. [26][27][28] The results were convincing and revealed a significantly higher degree of osseointegration for coated implants compared to neat PEEK.…”

“…10,11 PEEK is considered to be a relatively bioinert material and does not release ions, corrode or degrade in biological situations. [26][27][28] However, the increased bone formation and removal torque were most prominent for HA-PEEK after 3 weeks compared to 12 weeks. [12][13][14] Improving the bioactivity of PEEK is currently a major research topic and several methods and substances are under investigation.…”

Infection burden and immunological responses are equivalent for polymeric and metallic implant materials in vitro and in a murine model of fracture‐related infection

“…For example, Ti has been polished to a smoother surface, which has been shown to reduce bony integration . While modifications applied to PEEK to improve tissue integration include example oxygen‐plasma treatment to increase hydrophilicity, or hydroxyapatite coatings . To date there is limited evidence as to how Ti and PEEK, either in their standard or modified forms, affect implant‐associated infection risk.…”

Ultrastructural characteristics of ovine bone marrow‐derived mesenchymal stromal cells cultured with a silicon stabilized tricalcium phosphate bioceramic

“…Engineered bone substitutes are attractive because they are biocompatible, have osteogenic properties and good biological performance without the aforementioned limitations (Välimäaki, Yrjans, Vuorio, & Aro, ). Different kinds of synthetic materials, with many different characteristics have been studied including metals, ceramics, polymers, and composite materials (Cheng Shi, Ye, & Bu, ; Daei‐farshbaf et al, ; Johansson et al, ; Kido et al, ; Wan, He, & Li ; Zwingenberger et al, ). For tissue engineering, scaffolds and stem cells are the two essential components (Arvidson et al, ; Le Nihouannen et al, ).…”

“…Different kinds of synthetic materials, with many different characteristics have been studied including metals, ceramics, polymers, and composite materials (Cheng Shi, Ye, & Bu, 2013;Daei-farshbaf et al, 2014;Johansson et al, 2016;Kido et al, 2015;Wan, He, & Li 2006;Zwingenberger et al, 2012). For tissue engineering, scaffolds and stem cells are the two essential components (Arvidson et al, 2011;Le Nihouannen et al, 2007).…”