Engineering Multifunctional Polyether Ether Ketone Implant: Mechanics-Adaptability, Biominerialization, Immunoregulation, Anti-Infection, Osteointegration, and Osteogenesis

Polyether ether ketone (PEEK) has become one of the most promising polymer implants in bone orthopedics, due to the biocompatibility, good processability, and radiation resistance. However, the poor mechanics-adaptability/osteointegration/osteogenesis/antiinfection limits the long-term in vivo applications of PEEK implants. Herein, a multifunctional PEEK implant (PEEK-PDA-BGNs) is constructed through in situ surface deposition of polydopamine-bioactive glass nanoparticles (PDA-BGNs). PEEK-PDA-BGNs exhibit good performance on osteointegration and osteogenesis in vitro and in vivo, due to their multifunctional properties including mechanics-adaptability, biominerialization, immunoregulation, anti-infection, and osteoinductive activity. PEEK-PDA-BGNs can show the bone tissue-adaptable mechanic surface and induce the rapid biomineralization (apatite formation) under a simulated body solution. Additionally, PEEK-PDA-BGNs can induce the M2 phenotype polarization of macrophages, reduce the expression of inflammatory factors, promote the osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs), and improve the osseointegration and osteogenesis ability of the PEEK implant. PEEK-PDA-BGNs also show good photothermal antibacterial activity and can kill 99% of Escherichia coli (E. coli) and Methicillin-resistant Staphylococcus aureus (MRSA), suggesting their potential antiinfection ability. This work suggests that PDA-BGNs coating is probably a facile strategy to construct multifunctional (biomineralization, antibacterial, immunoregulation) implants for bone tissue replacement.

Modification of polyether ether ketone for the repairing of bone defects

Bone damage as a consequence of disease or trauma is a common global occurrence. For bone damage treatment - bone implant materials are necessary across three classifications of surgical intervention (i.e. fixation, repair, and replacement). Many types of bone implant materials have been developed to meet the requirements of bone repair. Among them, polyether ether ketone (PEEK) has been considered as one of the next generation of bone implant materials, owing to its advantages related to good biocompatibility, chemical stability, X-ray permeability, elastic modulus comparable to natural bone, as well as the ease of processing and modification. However, as PEEK is a naturally bioinert material, some modification is needed to improve its integration with adjacent bones after implantation. Therefore, it has become a very hot topic of biomaterials research and various strategies for the modification of PEEK including blending, 3D printing, coating, chemical modification and the introduction of bioactive and/or antibacterial substances have been proposed. In this systematic review, the recent advances in modification of PEEK and its application prospect as bone implants are summarized, and the remaining challenges are also discussed.

Safety assessment of the substance chopped carbon fibres, from carbonised polyacrylonitrile, for use in food contact materials

The EFSA Panel on Food Contact Materials, Enzymes and Processing Aids (CEP) assessed the safety of chopped carbon fibres, from carbonised polyacrylonitrile, as food contact material (FCM) substance No 1086, which is intended to be used as a filler for polyether ether ketone (PEEK) polymer at up to 40% w/w. The plastic is intended for repeated use in contact with all types of foods under all conditions of use. The chopped carbon fibres have a length of ■■■■■ and a diameter of ■■■■■, with no fragments lower than ■■■■■ in any dimension. They do not include a fraction of particles at the nanoscale and are fully embedded in the PEEK matrix, and therefore the fibres and any fragments are not expected to migrate. Based on the results of a battery of three genotoxicity tests, the Panel concluded that the substance does not raise a concern for genotoxicity. Therefore, the CEP Panel concluded that the substance chopped carbon fibres, from carbonised polyacrylonitrile, with a minimum carbon content of 95% (at sizes not at the nanoscale) does not raise a safety concern for the consumer if the substance is used as a filler at up to 40% w/w for PEEK plastic in contact with all food types and under all conditions of use.

Research on the Fused Deposition Modeling of Polyether Ether Ketone

As a special engineering polymer, polyether ether ketone (PEEK) has been used widely due to its excellent mechanical properties, high thermal stability, and chemical resistance. Fused deposition modeling (FDM) is a promising process for fabricating PEEK parts. However, due to the semi-crystalline property and high melting point of PEEK, determining appropriate process parameters is important to reduce warpage deformation and improve the mechanical properties of PEEK. In this article, the influence of raster angle and infill density was determined by single factor experiment, which are the two most important parameters. The results showed that samples with 0°/90° raster angle and 50% infill density had the best comprehensive properties in terms of warpage deformation, tensile strength, and specific strength. Subsequently, based on the results above, the effects of printing speed, nozzle temperature, platform temperature, raster width, and layer thickness were analyzed by orthogonal experiment. The results indicated that platform temperature had the greatest impact on warpage deformation while printing speed and nozzle temperature were significant parameters on tensile strength. Through optimization, warpage deformation of the samples could be reduced to almost 0 and tensile strength could increase by 19.6% (from 40.56 to 48.50 MPa). This will support the development of FDM for PEEK.

A Case Study of Polyether Ether Ketone (I): Investigating the Thermal and Fire Behavior of a High-Performance Material

The thermal and fire behaviors of a high-performance polymeric material-polyether ether ketone (PEEK) was investigated. The TG plots of PEEK under different oxygen concentrations revealed that the initial step of thermal decomposition does not greatly depend on the oxygen level. However, oxygen concentration plays a major role in the subsequent decomposition steps. In order to understand the thermal decomposition mechanism of PEEK several methods were employed, i.e., pyrolysis-gas chromatography-mass spectrometry (Py-GC-MS), thermogravimetric analysis (TGA) coupled with a Fourier-transform infrared spectrometer (FTIR). It was observed that the initial decomposition step of the material may lead to the release of noncombustible gases and the formation of a highly crosslinked graphite-like carbonaceous structure. Moreover, during the mass loss cone calorimetry test, PEEK has shown excellent charring and fire resistance when it is subjected to an incident heat flux of 50 kW/m². Based on the fire behavior and the identification of pyrolysis gases evolved during the decomposition of PEEK, the enhanced fire resistance of PEEK was assigned to the dilution of the flammable decomposition gases as well as the formation of a protective graphite-like charred structure during its decomposition. Moreover, at 60 kW/m², ignition occurred more quickly. This is because a higher rate of release of decomposition products is achieved at such a heat flux, causing a higher concentration of combustibles, thus an earlier ignition. However, the peak of heat release rate of the material did not exceed 125 kW/m².

A Randomized Controlled Trial of PEEK Versus Titanium Interference Screws for Anterior Cruciate Ligament Reconstruction With 2-Year Follow-up

BACKGROUND

Graft fixation with interference screws for anterior cruciate ligament (ACL) reconstruction is a highly successful technique. Polyether ether ketone (PEEK) is a novel thermoplastic polymer with high biocompatibility and mechanical properties that mimic native bone, and it can be imaged on computed tomography or magnetic resonance imaging (MRI) without signal flare.

PURPOSE

To compare the clinical performance of ACL reconstruction with PEEK and titanium interference screws at 2 years and to evaluate a novel method of measuring tunnel volume.

STUDY DESIGN

Randomized controlled trial; Level of evidence, 1.

METHODS

A total of 133 patients underwent arthroscopic ACL reconstruction with 4-strand hamstring autografts and were randomized to have titanium or PEEK interference screws for femoral and tibial tunnel fixation. At 2 years, subjective Lysholm and International Knee Documentation Committee scores were assessed and clinical examination performed. At 12 months, MRI was performed to assess graft incorporation and cyst formation, and a novel technique was employed to measure tunnel volumes.

RESULTS

There were no significant differences in graft rerupture rate, contralateral ACL rupture rate, subjective outcomes, or objective outcomes. In the titanium and PEEK groups, MRI demonstrated high overall rates of graft integration (96%-100% and 90%-93%, respectively) and ligamentization (89% and 84%) and low rates of synovitis (22% and 10%) and cyst formation (0%-18% and 13%-15%). There was a higher proportion of patients with incomplete graft integration within the femoral tunnel in the PEEK group as compared with the titanium group (10% vs 0%, P = .03); however, the authors suggest that metal artifact precluded proper assessment of the graft in the titanium group by MRI. Tunnel volumes also appeared to be equivalent in the 2 groups and were measured with a novel technique that was highly reproducible in the PEEK group secondary to the absence of flare.

CONCLUSION

Two-year clinical analysis of PEEK interference screws for femoral and tibial fixation of ACL reconstructions showed equivalent clinical performance to titanium interference screws. Given the excellent mechanical characteristics, biological compatibility, and absence of metal artifact on MRI, PEEK has become our material of choice for interference screw fixation in ACL reconstruction.