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Review
. 2022 Aug 19:16:100402.
doi: 10.1016/j.mtbio.2022.100402. eCollection 2022 Dec.

Strategies to improve bioactive and antibacterial properties of polyetheretherketone (PEEK) for use as orthopedic implants

Zhi Zheng  1   2 , Pengjia Liu  3 , Xingmin Zhang  1   2 , Jingguo Xin  1   2 , Yongjie Wang  1   2 , Xiaosong Zou  1   2 , Xiaohan Mei  4 , Shuling Zhang  4 , Shaokun Zhang  1   2
Affiliations
Review

Strategies to improve bioactive and antibacterial properties of polyetheretherketone (PEEK) for use as orthopedic implants

Zhi Zheng et al. Mater Today Bio. .

Abstract

Polyetheretherketone (PEEK) has gradually become the mainstream material for preparing orthopedic implants due to its similar elastic modulus to human bone, high strength, excellent wear resistance, radiolucency, and biocompatibility. Since the 1990s, PEEK has increasingly been used in orthopedics. Yet, the widespread application of PEEK is limited by its bio-inertness, hydrophobicity, and susceptibility to microbial infections. Further enhancing the osteogenic properties of PEEK-based implants remains a difficult task. This article reviews some modification methods of PEEK in the last five years, including surface modification of PEEK or incorporating materials into the PEEK matrix. For surface modification, PEEK can be modified by chemical treatment, physical treatment, or surface coating with bioactive substances. For PEEK composite material, adding bioactive filler into PEEK through the melting blending method or 3D printing technology can increase the biological activity of PEEK. In addition, some modification methods such as sulfonation treatment of PEEK or grafting antibacterial substances on PEEK can enhance the antibacterial performance of PEEK. These strategies aim to improve the bioactive and antibacterial properties of the modified PEEK. The researchers believe that these modifications could provide valuable guidance on the future design of PEEK orthopedic implants.

Keywords: Antibacterial properties; Biocompatibility; Coating; Composite; Modification; Orthopedic implants; Polyetheretherketone.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Image 1
Graphical abstract
Fig. 1
Fig. 1
Example clinical uses of modified PEEK.
Fig. 2
Fig. 2
Characteristics of PEEK implants after modification. Abbreviation: ALP, Alkaline Phosphatase; OCN, Osteocalcin; OPN, Osteopontin; BMP-2, Bone morphogenetic protein 2.
Fig. 3
Fig. 3
PEEK modification strategies to improve bioactivity. Abbreviation: ANAB, Accelerated Neutral Atom Beam; IBAD, Ion Beam Assisted Deposition; HA, hydroxyapatite.
Fig. 4
Fig. 4
(A) Size of PEEK implants. (B) Surgical site with an implant inserted. (C, D) X-rays after implantation (arrows indicate the defect boundaries) [47]; Reproduced with permission of Ref.
Fig. 5
Fig. 5
Schematic diagram of the preparation of three-dimensional porous sulfonated PEEK. SPEEK-W: sulfonated PEEK after drying; SPEEK-WA: sulfonated PEEK rinsed with acetone [88]; Reproduced with permission of Ref.
Fig. 6
Fig. 6
PEEK surface nanotopography promotes osteoblast differentiation [123]; Reproduced with permission of Ref.
Fig. 7
Fig. 7
Schematic diagram of preparation and characterization of graphene-coated sulfonated CF-PEEK [140]. Ra: Roughness average. Reproduced with permission of Ref.
Fig. 8
Fig. 8
Modification strategies of PEEK to improve antibacterial property.
See this image and copyright information in PMC

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