Retrieval analysis of PEEK rods for posterior fusion and motion preservation

Kurtz, Steven M.; Lanman, Todd H.; Higgs, Genymphas B.; MacDonald, Daniel W.; Berven, Sigurd; Isaza, Jorge; Steinbeck, Marla J.

doi:10.1007/s00586-013-2920-4

Cited by 30 publications

(19 citation statements)

References 12 publications

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“…In some cases, there was an emerging difficulty to distinguish between wear-induced and iatrogenic damages due to revision surgery, as already reported by Kurtz et al [33]. The reduced average roughness in worn areas found in this study has been already documented for a retrieved CFR-PEEK acetabular liner adjacent to an alumina head [34] and for CFR-PEEK acetabular cups tested within a simulator study [17].…”

Section: Discussionsupporting

confidence: 72%

Analysis of Carbon Fiber Reinforced PEEK Hinge Mechanism Articulation Components in a Rotating Hinge Knee Design: A Comparison of In Vitro and Retrieval Findings

Schierjott

Giurea

Neuhaus

et al. 2016

BioMed Research International

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Carbon fiber reinforced poly-ether-ether-ketone (CFR-PEEK) represents a promising alternative material for bushings in total knee replacements, after early clinical failures of polyethylene in this application. The objective of the present study was to evaluate the damage modes and the extent of damage observed on CFR-PEEK hinge mechanism articulation components after in vivo service in a rotating hinge knee (RHK) system and to compare the results with corresponding components subjected to in vitro wear tests. Key question was if there were any similarities or differences between in vivo and in vitro damage characteristics. Twelve retrieved RHK systems after an average of 34.9 months in vivo underwent wear damage analysis with focus on the four integrated CFR-PEEK components and distinction between different damage modes and classification with a scoring system. The analysis included visual examination, scanning electron microscopy, and energy dispersive X-ray spectroscopy, as well as surface roughness and profile measurements. The main wear damage modes were comparable between retrieved and in vitro specimens (n = 3), whereby the size of affected area on the retrieved components showed a higher variation. Overall, the retrieved specimens seemed to be slightly heavier damaged which was probably attributable to the more complex loading and kinematic conditions in vivo.

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Section: Discussionsupporting

confidence: 72%

Analysis of Carbon Fiber Reinforced PEEK Hinge Mechanism Articulation Components in a Rotating Hinge Knee Design: A Comparison of In Vitro and Retrieval Findings

Schierjott

Giurea

Neuhaus

et al. 2016

BioMed Research International

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“…One of them is polyetheretherketone, whose application is becoming greater and greater. [2] To improve PEEK's biocompatibility, the surface was enriched with hydroxyapatite (HA) during polymerization process. Besides, based on past studies, PEEK is well tolerated by the nervous tissue and thus it can be used as a component in the spinal implant.…”

Section: Introduction 1| Peek Application As Implantsmentioning

confidence: 99%

Influence of nitrogen plasma treatment on the wettability of polyetheretherketone and deposited chitosan layers

2017

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Wettability properties of polyetheretherketone (PEEK) activated and non-activated by nitrogen plasma have been investigated. Moreover, the PEEK plates were covered with antibacterial chitosan and its wettability properties were also investigated. Surface topography was determined using SEM and optical profilometry and surface composition by FT-IR and XPS. For determination of apparent surface free energy, the hysteresis approach (CAH), acid base (LWAB), and Owens-Wendt (O-W) theory were used. The equilibrium contact angles were calculated from the Tadmor theory and further used for apparent surface energy calculation applying the abovementioned approaches. Due to the surface plasma activation both the roughness of the surface and the polar component of apparent surface free energy increased. It is shown that nitrogen plasma activation of PEEK surface increases the adhesion of chitosan to the surface due to the combination effect of: (i) the increase in surface roughness, (ii) introducing the polar groups onto the surface. K E Y W O R D S chitosan, low-temperature plasma activation, polyetheretherketone, surface free energy, wettability How to cite this article: Terpiłowski K, Wiącek AE, Jurak M. Influence of nitrogen plasma treatment on the wettability of polyetheretherketone and deposited chitosan layers. Adv Polym Technol. 2018;37:1557-1569.

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“…Patient age ranged from 35 to 64 years (mean 6 SD: 52 6 10 years); 8 patients (66.7%, 8/12) were female, and the implantation time of the PEEK rods ranged from 0.5 to 2.8 years (mean 6 SD: 1.7 6 0.8 years). 21 All the patients in this study were revised for intractable pain, although the mechanism varied and was confirmed by intraoperative findings. The most frequently reported reasons (58.0%, 7/12) for revision among the PEEK rod patients who underwent spinal fusion included adjacent segment disease in 3 patients, device-related muscular paravertebral pain in 2 patients, and pseudoarthrosis in 2 patients.…”

Section: Peek (N) Fusion Rate (%) Notesmentioning

confidence: 76%

“…19 These data are in alignment with the functional improvement outcomes. 21 Twelve patients with PEEK rods underwent revision surgery, and their posterior instrumentation was retrieved. Patient age ranged from 35 to 64 years (mean 6 SD: 52 6 10 years); 8 patients (66.7%, 8/12) were female, and the implantation time of the PEEK rods ranged from 0.5 to 2.8 years (mean 6 SD: 1.7 6 0.8 years).…”

Section: Peek (N) Fusion Rate (%) Notesmentioning

confidence: 99%

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Polyetheretherketone (PEEK) Rods for Lumbar Fusion: A Systematic Review and Meta-Analysis

2018

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Background: The purpose of this systematic review is to evaluate the safety and effectiveness of polyetheretherketone (PEEK) rod systems in patients receiving lumbar interbody fusion treatment. Meta-analyses of relevant clinical data were also conducted when possible. Methods: Relevant studies were identified by searching the PubMed, EMBASE, and Cochrane Library databases. Clinical studies evaluating the safety and/or effectiveness of the PEEK rod spinal stabilization system in patients receiving lumbar spinal fusion procedure were included. Studies regarding dynamic stabilization and hybrid stabilization (fixed and dynamic; eg, topping-off technique) were not included in this analysis. The analyses included patients who had a lumbar fusion procedure with PEEK rods or titanium rods as a control reference (only for controlled studies). Fusion success, functional and pain improvement, and safety data were evaluated, if reported. Results: The search yielded 5 studies (1 prospective and 4 retrospectives) that included 177 participants (156 received PEEK rods, and 21 received titanium rods). Meta-analysis of interbody fusion success rate in PEEK rod patients yields the estimate of 95.6% (confidence interval: 91.6% to 98.4%). Functional outcomes in PEEK rod patients demonstrated clinically significant improvement when comparing postoperative to preoperative scores, with an average improvement of 67.4% 6 8.5%. Similarly, pain improvement was clinically significant with an average visual analog scores-back pain and visual analog scores-leg pain improvement percentages of 68.9% 6 8.6% and 76.6% 6 1.5%, respectively. Rod fracture was not reported in any of the studies. The rates of screw fracture and loosening were 3/114 (2.6%) and 1/50 (2.0%), respectively. In the controlled study, no statistically significant difference was reported in the fusion success rate, function improvement, pain improvement, or device-related events between subjects treated with PEEK rods and the subjects treated with titanium rods. Conclusions: Experience with PEEK rod systems has shown satisfactory clinical outcomes. Therefore, these results support the use of PEEK rod systems as supplemental fixation during lumbar fusion procedures.

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Retrieval analysis of PEEK rods for posterior fusion and motion preservation

Abstract: This study documents the surface changes and tissue reactions for retrieved PEEK rod stabilization systems. Permanent indentations by the set screws and pedicle screws were the most prevalent observations on the surface of explanted PEEK rods.

Cited by 30 publications

References 12 publications

Analysis of Carbon Fiber Reinforced PEEK Hinge Mechanism Articulation Components in a Rotating Hinge Knee Design: A Comparison of In Vitro and Retrieval Findings

Analysis of Carbon Fiber Reinforced PEEK Hinge Mechanism Articulation Components in a Rotating Hinge Knee Design: A Comparison of In Vitro and Retrieval Findings

Influence of nitrogen plasma treatment on the wettability of polyetheretherketone and deposited chitosan layers

Polyetheretherketone (PEEK) Rods for Lumbar Fusion: A Systematic Review and Meta-Analysis

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