Current Strategies to Improve the Bioactivity of PEEK
Identifieur interne : 000815 ( Pmc/Curation ); précédent : 000814; suivant : 000816Current Strategies to Improve the Bioactivity of PEEK
Auteurs : Rui Ma ; Tingting TangSource :
- International Journal of Molecular Sciences [ 1422-0067 ] ; 2014.
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.
Url:
DOI: 10.3390/ijms15045426
PubMed: 24686515
PubMed Central: 4013573
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Current Strategies to Improve the Bioactivity of PEEK</title><author><name sortKey="Ma, Rui" sort="Ma, Rui" uniqKey="Ma R" first="Rui" last="Ma">Rui Ma</name></author><author><name sortKey="Tang, Tingting" sort="Tang, Tingting" uniqKey="Tang T" first="Tingting" last="Tang">Tingting Tang</name></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">24686515</idno><idno type="pmc">4013573</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4013573</idno><idno type="RBID">PMC:4013573</idno><idno type="doi">10.3390/ijms15045426</idno><date when="2014">2014</date><idno type="wicri:Area/Pmc/Corpus">000815</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000815</idno><idno type="wicri:Area/Pmc/Curation">000815</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000815</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Current Strategies to Improve the Bioactivity of PEEK</title><author><name sortKey="Ma, Rui" sort="Ma, Rui" uniqKey="Ma R" first="Rui" last="Ma">Rui Ma</name></author><author><name sortKey="Tang, Tingting" sort="Tang, Tingting" uniqKey="Tang T" first="Tingting" last="Tang">Tingting Tang</name></author></analytic><series><title level="j">International Journal of Molecular Sciences</title><idno type="eISSN">1422-0067</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>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.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Adell, R" uniqKey="Adell R">R. Adell</name></author><author><name sortKey="Lekholm, U" uniqKey="Lekholm U">U. 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Int J Mol Sci</journal-id><journal-id journal-id-type="iso-abbrev">Int J Mol Sci</journal-id><journal-id journal-id-type="publisher-id">ijms</journal-id><journal-title-group><journal-title>International Journal of Molecular Sciences</journal-title></journal-title-group><issn pub-type="epub">1422-0067</issn><publisher><publisher-name>Molecular Diversity Preservation International (MDPI)</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">24686515</article-id><article-id pub-id-type="pmc">4013573</article-id><article-id pub-id-type="doi">10.3390/ijms15045426</article-id><article-id pub-id-type="publisher-id">ijms-15-05426</article-id><article-categories><subj-group subj-group-type="heading"><subject>Review</subject></subj-group></article-categories><title-group><article-title>Current Strategies to Improve the Bioactivity of PEEK</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Ma</surname><given-names>Rui</given-names></name></contrib><contrib contrib-type="author"><name><surname>Tang</surname><given-names>Tingting</given-names></name><xref rid="c1-ijms-15-05426" ref-type="corresp">*</xref></contrib><aff id="af1-ijms-15-05426">Shanghai Key Laboratory of Orthopedic Implants, Department of Orthopedic Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China; E-Mail:<email>shandongmarui@126.com</email></aff></contrib-group><author-notes><corresp id="c1-ijms-15-05426"><label>*</label>Author to whom correspondence should be addressed; E-Mail: <email>tingtingtang@hotmail.com</email> or <email>ttt@sjtu.edu.cn</email>; Tel.: +86-21-2327-1133; Fax: +86-21-6313-7020.</corresp></author-notes><pub-date pub-type="collection"><month>4</month><year>2014</year></pub-date><pub-date pub-type="epub"><day>28</day><month>3</month><year>2014</year></pub-date><volume>15</volume><issue>4</issue><fpage>5426</fpage><lpage>5445</lpage><history><date date-type="received"><day>03</day><month>1</month><year>2014</year></date><date date-type="rev-recd"><day>14</day><month>3</month><year>2014</year></date><date date-type="accepted"><day>24</day><month>3</month><year>2014</year></date></history><permissions><copyright-statement>© 2014 by the authors; licensee MDPI, Basel, Switzerland</copyright-statement><copyright-year>2014</copyright-year><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/3.0/"><license-p><pmc-comment>CREATIVE COMMONS</pmc-comment>This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution license (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/3.0/">http://creativecommons.org/licenses/by/3.0/</ext-link>).</license-p></license></permissions><abstract><p>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.</p></abstract><kwd-group><kwd>polyetheretherketone</kwd><kwd>bioactivity</kwd><kwd>surface modification</kwd><kwd>coating</kwd><kwd>composite</kwd></kwd-group></article-meta></front><floats-group><fig id="f1-ijms-15-05426" position="float"><label>Figure 1.</label><caption><p>Scheme of current strategies to improve the bioactivity of PEEK.</p></caption><graphic xlink:href="ijms-15-05426f1"></graphic></fig><table-wrap id="t1-ijms-15-05426" position="float"><label>Table 1.</label><caption><p>The reported PEEK composites that are concerned with the bioactivity of the composites.</p></caption><table frame="hsides" rules="rows"><thead><tr><th align="left" valign="middle" rowspan="1" colspan="1">PEEK composites</th><th align="left" valign="middle" rowspan="1" colspan="1">Fillers (name, size, form)</th><th align="left" valign="middle" rowspan="1" colspan="1">Processing techniques</th><th align="left" valign="middle" rowspan="1" colspan="1">Research results related the bioactivity of the composites</th><th align="left" valign="middle" rowspan="1" colspan="1">Reference</th></tr></thead><tbody><tr><td align="left" valign="middle" rowspan="1" colspan="1">HA/PEEK</td><td align="left" valign="middle" rowspan="1" colspan="1">Conventional HA particles</td><td align="left" valign="middle" rowspan="1" colspan="1">Melt compounding, granulation and injection molding</td><td align="left" valign="middle" rowspan="1" colspan="1">N/R</td><td align="left" valign="middle" rowspan="1" colspan="1">[<xref rid="b63-ijms-15-05426" ref-type="bibr">63</xref>,<xref rid="b64-ijms-15-05426" ref-type="bibr">64</xref>,<xref rid="b66-ijms-15-05426" ref-type="bibr">66</xref>,<xref rid="b67-ijms-15-05426" ref-type="bibr">67</xref>]</td></tr><tr><td align="left" valign="middle" rowspan="1" colspan="1">HA/PEEK</td><td align="left" valign="middle" rowspan="1" colspan="1">Conventional HA whiskers</td><td align="left" valign="middle" rowspan="1" colspan="1">Powder processing and compression molding</td><td align="left" valign="middle" rowspan="1" colspan="1">N/R</td><td align="left" valign="middle" rowspan="1" colspan="1">[<xref rid="b65-ijms-15-05426" ref-type="bibr">65</xref>]</td></tr><tr><td align="left" valign="middle" rowspan="1" colspan="1">HA/PEEK</td><td align="left" valign="middle" rowspan="1" colspan="1">Conventional HA particles</td><td align="left" valign="middle" rowspan="1" colspan="1">Selective laser sintering</td><td align="left" valign="middle" rowspan="1" colspan="1">Cell tests: with improved osteoblast growth compared to TMX and PVC; higher HA contents with enhanced cell proliferation and osteogenic differentiation.</td><td align="left" valign="middle" rowspan="1" colspan="1">[<xref rid="b68-ijms-15-05426" ref-type="bibr">68</xref>]</td></tr><tr><td align="left" valign="middle" rowspan="1" colspan="1">HA/PEEK</td><td align="left" valign="middle" rowspan="1" colspan="1">Conventional HA powders</td><td align="left" valign="middle" rowspan="1" colspan="1"><italic>In situ</italic> synthetic process</td><td align="left" valign="middle" rowspan="1" colspan="1"><italic>In vivo</italic>: the new bone tissues surrounding the composite grow faster with a higher HA content.</td><td align="left" valign="middle" rowspan="1" colspan="1">[<xref rid="b69-ijms-15-05426" ref-type="bibr">69</xref>,<xref rid="b70-ijms-15-05426" ref-type="bibr">70</xref>]</td></tr><tr><td align="left" valign="middle" rowspan="1" colspan="1">HA/PEEK</td><td align="left" valign="middle" rowspan="1" colspan="1">Conventional HA powders</td><td align="left" valign="middle" rowspan="1" colspan="1">Mixing, compaction and pressureless sintering</td><td align="left" valign="middle" rowspan="1" colspan="1">SBF immersion test: the 40 vol %-HA composite was covered by apatite-layer after 3 days; the growth rate increased with HA volume fraction.</td><td align="left" valign="middle" rowspan="1" colspan="1">[<xref rid="b72-ijms-15-05426" ref-type="bibr">72</xref>]</td></tr><tr><td align="left" valign="middle" rowspan="1" colspan="1">Porous HA/PEEK</td><td align="left" valign="middle" rowspan="1" colspan="1">Conventional HA particles</td><td align="left" valign="middle" rowspan="1" colspan="1">Leaching of particulate technique</td><td align="left" valign="middle" rowspan="1" colspan="1"><italic>In vivo</italic>: formation of fibro-vascular tissue within the pores at 6 weeks and mature bone at 16 weeks.</td><td align="left" valign="middle" rowspan="1" colspan="1">[<xref rid="b66-ijms-15-05426" ref-type="bibr">66</xref>]</td></tr><tr><td align="left" valign="middle" rowspan="1" colspan="1">Porous HA/PEEK</td><td align="left" valign="middle" rowspan="1" colspan="1">Conventional HA powers</td><td align="left" valign="middle" rowspan="1" colspan="1">Selective laser sintering</td><td align="left" valign="middle" rowspan="1" colspan="1">SBF immersion test and cell tests: with precipitation of apatite-layers; with positive cell adhesion and growth compared to control (no specimens).</td><td align="left" valign="middle" rowspan="1" colspan="1">[<xref rid="b74-ijms-15-05426" ref-type="bibr">74</xref>,<xref rid="b75-ijms-15-05426" ref-type="bibr">75</xref>]</td></tr><tr><td align="left" valign="middle" rowspan="1" colspan="1">Sr-HA/ PEEK</td><td align="left" valign="middle" rowspan="1" colspan="1">Conventional Sr-HA powers</td><td align="left" valign="middle" rowspan="1" colspan="1">Mixing, compression and molding</td><td align="left" valign="middle" rowspan="1" colspan="1">SBF immersion test and cell tests: with improved apatite-formation ability and mineralization compared to HA/PEEK or pure PEEK.</td><td align="left" valign="middle" rowspan="1" colspan="1">[<xref rid="b77-ijms-15-05426" ref-type="bibr">77</xref>]</td></tr><tr><td align="left" valign="middle" rowspan="1" colspan="1">CS/PEEK</td><td align="left" valign="middle" rowspan="1" colspan="1">Conventional CS powers</td><td align="left" valign="middle" rowspan="1" colspan="1">Mixing and compaction</td><td align="left" valign="middle" rowspan="1" colspan="1">SBF immersion test: except for pure PEEK, all of the CS-containing composites promoted apatite-formation.</td><td align="left" valign="middle" rowspan="1" colspan="1">[<xref rid="b78-ijms-15-05426" ref-type="bibr">78</xref>]</td></tr><tr><td align="left" valign="middle" rowspan="1" colspan="1">Glass/PEEK</td><td align="left" valign="middle" rowspan="1" colspan="1">Conventional Chopped E-glass fibers</td><td align="left" valign="middle" rowspan="1" colspan="1">N/A</td><td align="left" valign="middle" rowspan="1" colspan="1">Cell tests: with improved cell proliferation, ALP activity and OC production compared to polystyrene.</td><td align="left" valign="middle" rowspan="1" colspan="1">[<xref rid="b79-ijms-15-05426" ref-type="bibr">79</xref>]</td></tr><tr><td align="left" valign="middle" rowspan="1" colspan="1">β-TCP/PEEK</td><td align="left" valign="middle" rowspan="1" colspan="1">Conventional β-TCP powers</td><td align="left" valign="middle" rowspan="1" colspan="1">Injection and molding</td><td align="left" valign="middle" rowspan="1" colspan="1">Cell tests: with inhibited cell proliferation, but with no concentration-dependent decrease.</td><td align="left" valign="middle" rowspan="1" colspan="1">[<xref rid="b83-ijms-15-05426" ref-type="bibr">83</xref>]</td></tr><tr><td align="left" valign="middle" rowspan="1" colspan="1">Carbon black/ β-TCP/PEEK</td><td align="left" valign="middle" rowspan="1" colspan="1">Nano-sized carbon black powers, Conventional β-TCP powers</td><td align="left" valign="middle" rowspan="1" colspan="1">Laser sintering</td><td align="left" valign="middle" rowspan="1" colspan="1">Cell tests: with no improvement of cell proliferation compared to pure PEEK and carbon black/PEEK.</td><td align="left" valign="middle" rowspan="1" colspan="1">[<xref rid="b81-ijms-15-05426" ref-type="bibr">81</xref>,<xref rid="b82-ijms-15-05426" ref-type="bibr">82</xref>]</td></tr><tr><td align="left" valign="middle" rowspan="1" colspan="1">Carbon black/ bioglass/PEEK</td><td align="left" valign="middle" rowspan="1" colspan="1">Nano-sized carbon black powers, Conventional bioglass powers</td><td align="left" valign="middle" rowspan="1" colspan="1">Laser sintering</td><td align="left" valign="middle" rowspan="1" colspan="1">Cell tests: with improvement of cell proliferation compared to PEEK, carbon black/PEEK, and carbon black/β-TCP/PEEK.</td><td align="left" valign="middle" rowspan="1" colspan="1">[<xref rid="b82-ijms-15-05426" ref-type="bibr">82</xref>]</td></tr><tr><td align="left" valign="middle" rowspan="1" colspan="1">HA/PEEK</td><td align="left" valign="middle" rowspan="1" colspan="1">Nano-sized HA particles</td><td align="left" valign="middle" rowspan="1" colspan="1">Compounding and injection molding</td><td align="left" valign="middle" rowspan="1" colspan="1">N/R</td><td align="left" valign="middle" rowspan="1" colspan="1">[<xref rid="b84-ijms-15-05426" ref-type="bibr">84</xref>,<xref rid="b85-ijms-15-05426" ref-type="bibr">85</xref>]</td></tr><tr><td align="left" valign="middle" rowspan="1" colspan="1">HA/PEEK</td><td align="left" valign="middle" rowspan="1" colspan="1">Nano-sized HA particles</td><td align="left" valign="middle" rowspan="1" colspan="1"><italic>In situ</italic> synthetic process</td><td align="left" valign="middle" rowspan="1" colspan="1">N/R</td><td align="left" valign="middle" rowspan="1" colspan="1">[<xref rid="b88-ijms-15-05426" ref-type="bibr">88</xref>]</td></tr><tr><td align="left" valign="middle" rowspan="1" colspan="1">HA/PEEK</td><td align="left" valign="middle" rowspan="1" colspan="1">Nano-sized HA rods</td><td align="left" valign="middle" rowspan="1" colspan="1">Powder processing and sintering</td><td align="left" valign="middle" rowspan="1" colspan="1">Cell tests: with improved apatite-formation ability, cell adhesion and proliferation compared to pure PEEK.</td><td align="left" valign="middle" rowspan="1" colspan="1">[<xref rid="b98-ijms-15-05426" ref-type="bibr">98</xref>]</td></tr><tr><td align="left" valign="middle" rowspan="1" colspan="1">TiO<sub>2</sub>/PEEK</td><td align="left" valign="middle" rowspan="1" colspan="1">Nano-sized TiO<sub>2</sub> particles</td><td align="left" valign="middle" rowspan="1" colspan="1">Mixing compression and molding</td><td align="left" valign="middle" rowspan="1" colspan="1">Cell tests: with improved cell attachment and spreading compared with pure PEEK;<break></break><italic>In vivo</italic>: with improved bone regeneration around the implants compared to pure PEEK.</td><td align="left" valign="middle" rowspan="1" colspan="1">[<xref rid="b99-ijms-15-05426" ref-type="bibr">99</xref>]</td></tr></tbody></table><table-wrap-foot><fn id="tfn1-ijms-15-05426"><p>N/A, not applicable; N/R, not 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