Three-Dimensionally-Printed Polyether-Ether-Ketone Implant with a Cross-Linked Structure and Acid-Etched Microporous Surface Promotes Integration with Soft Tissue

Abstract

Polyether-ether-ketone (peek) is one of the most common materials used for load-bearing orthopedic devices owing to its radiolucency and favorable mechanical properties. However, current smooth-surfaced peek implants can lead to fibrous capsule formation. To overcome this issue, here, peek specimens with well-defined internal cross-linked structures (macropore diameters of 1.0–2.0 mm) were fabricated using a three-dimensional (3D) printer, and an acid-etched microporous surface was achieved using injection-molding technology. The cell adhesion properties of smooth and microporous peek specimens was compared in vitro through a scanning electron microscope (SEM), and the soft tissue responses to the both microporous and cross-linked structure of different groups were determined in vivo using a New Zealand white rabbit model, and examined through histologic staining and separating test. The results showed that the acid-etched microporous surface promoted human skin fibroblasts (HSF) adherence, while internal cross-linked structure improved the ability of the peek specimen to form a mechanical combination with soft tissue, especially with the 1.5 mm porous specimen. The peek specimens with both the internal cross-linked structure and external acid-etched microporous surface could effectively promote the close integration of soft tissue and prevent formation of fibrous capsules, demonstrating the potential for clinical application in surgical repair.

Biomechanical effects of reconstruction of the posterior structures after laminectomy with an individualized poly-ether-ether-ketone (PEEK) artificial lamina

“…However, PEEK, as an inert and hydrophobic material, lacks enough osseointegration property and is prone to form a loose soft tissue capsule around it. 28 These properties seem to be the key obstacles to translate our results to the clinical application. Although a large amount of literature has reported that osseointegration and soft tissue binding ability of PEEK materials can be enhanced through structural or surface modification.…”

“…Although a large amount of literature has reported that osseointegration and soft tissue binding ability of PEEK materials can be enhanced through structural or surface modification. [28][29][30] Further animal and related experiments are still necessary for these issues.…”

Material characterization and Streptococcus oralis adhesion on Polyetheretherketone (PEEK) and titanium surfaces used in implantology

“…Moreover, another advantage of PEEK is the possibility to modify its mechanical properties, by filling or mixing it with other elements, like carbonium fibers, increasing the elastic modulus to 18 GPa, that is similar to the 15 GPa cortical bone [4,7]. Other advantages of PEEK are biocompatibility, chemical and physical stability, esthetics, because its color is similar to the tooth and the possibility to be manufactured by means of 3D printers [8][9][10]. The use of PEEK in implantology also permits to overlap the problem of titanium hyper sensibility, allergy and other problems connected with ions release [11].…”

A microporous surface containing Si3N4/Ta microparticles of PEKK exhibits both antibacterial and osteogenic activity for inducing cellular response and improving osseointegration

“…Polyetherketoneketone (PEKK) and polyetheretherketone (PEEK) are two representative types of PAEK family [ 1 , 2 ]. PEEK exhibits great potential for bone repair owing to its superior mechanical properties, and has been extensively used in spinal fusion, trauma, dental and joint replacement, and cranio-maxillofacial repair [ 3 ]. Recently, PEKK, as another representative PAEK family material, is being increasingly researched and developed as a potential implantable material for orthopedic application because it shows better potential for orthopedic and spinal as well as dental application than PEEK [ 4 ].…”