Abstract
The synthetic thermoplastic polymer polyetheretherketone (PEEK) is becoming a popular component of clinical orthopedic and spinal applications, but its practical use suffers from several limitations. Although PEEK is biocompatible, chemically stable, radiolucent and has an elastic modulus similar to that of normal human bone, it is biologically inert, preventing good integration with adjacent bone tissues upon implantation. Recent efforts have focused on increasing the bioactivity of PEEK to improve the bone-implant interface. Two main strategies have been used to overcome the inert character of PEEK. One approach is surface modification to activate PEEK through surface treatment alone or in combination with a surface coating. Another strategy is to prepare bioactive PEEK composites by impregnating bioactive materials into PEEK substrate. Researchers believe that modified bioactive PEEK will have a wide range of orthopedic applications.
Highlights
Aging related aggravation and increases in accidental injuries have resulted in a sharp increase in the incidence of many diseases related to the bone and joint system, including fracture, vertebral degeneration, arthritis, bone tumors and tuberculosis
The results showed that SPEEK-WA induced pre-osteoblast functions including initial cell adhesion, proliferation, and osteogenic differentiation in vitro as well as substantially enhanced osseointegration and bone-implant bonding strength in vivo and apatite-forming ability
Some ceramics, such as HA, TCP, calcium silicate (CS), bioglass, glass-ceramic A-W, are referred to as bioactive materials due to their ability to spontaneously bond to living bone, and these materials are already used as bone substitutes with important clinical applications [9]
Summary
Aging related aggravation and increases in accidental injuries have resulted in a sharp increase in the incidence of many diseases related to the bone and joint system, including fracture, vertebral degeneration, arthritis, bone tumors and tuberculosis. Orthopedic implant materials commonly used in the clinic mainly include metals, ceramics, polymers and composites. Metals can provide favorable mechanical strength, excellent friction-resistance and non-toxic properties [1,2,3]; some notable disadvantages have hindered their more widely medical applications [4,5,6,7,8] Their high strength and elastic modulus that do not match those of normal human bone tissues can cause a stress shielding effect on the peri-implant bones, which will led to adsorption of adjacent bone tissues and cause prosthetic loosening. The mechanical properties of these materials, including their low fracture toughness and ductility, high elastic modulus and brittleness, cannot meet the demands of the load-bearing applications [9]. Two major strategies have been used to improve the bioactivity of PEEK, including surface modification and composite preparation, which will be reviewed in our present article
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