Plasma-sprayed titanium coating to polyetheretherketone improves

the bone-implant interface

By:
Esau Mhandu
American University of Beirut
MS Biomedical Engineering
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Importance of the Study
• There is need for rapid and stable fixation at the bone-implant interface
• Poyletheretherketone (PEEK) is an organic thermoplastic polymer used as a
biomaterial for implants due to its excellent mechanical and chemical properties
• PEEK is limited by its hydrophobic nature resulting in lack of direct bone contact
• The importance of the research is to present an implant interface that would support
early integration and long-term stability of the implant-bone interface
• This provides benefits of reducing implant complications – expulsion and nonunion
Hypothesis
The application of a plasma-sprayed
titanium layer to PEEK encourages early
bone-fixation and improve the mechanical
properties at the bone-implant interface

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 Methodology
• Cylindrical dowels (6 mm diameter x 20 mm long) of PEEK and PEEK
with plasma sprayed coating titanium (Ti-bond) were used
• Surface roughness was examined using microscopes
• 4 skeletally mature adult male sheep were used (Sample size was
determined based on the prehoc power analysis)
• 10 implant dowels were surgically implanted into surgically created
defects in the cancellous bone (4 sites) of the distal femur and proximal
tibia and the cortical bone (6 sites) of the distal diaphysis
• Animal were euthanized at 4-12 weeks after surgery

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Methodology
• Surgical sites were inspected for any
signs of adverse reactions
• Femur and tibia were radiographed
with x-ray machine to evaluate the
implant-bone interfaces
• Shear strength (MPa) of bone-
implant interface was determined
• Histomorphometric analysis was
performed to determine extent of
direct bone contact in the cortical and
cancellous implantation sites
• SPSS was used for statistical testing
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 Results

• Stereo zoom microscope and electron microscope, respectively, show appearance of coated
PEEK (Ti-bond) and PEEK
• Ti-bind demonstrates a rough topography for bone ongrowth and cavities for bone ingrowth

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Results
• Histology in cortical and cancellous sites
shows that Ti-bond implants had direct
bone ongrowth at 4 weeks (A) and 12
weeks (C), whereas the PEEK samples
presented a fibrous tissues tissue interface
with limited direct bone contact due to the
hydrophobic nature of PEEK
• New bone formation was present in the Ti-
bind coating
• Plasma-sprayed titanium coating applied to
the PEEK provides means for direct bone
ongrowth in cortical and cancellous sites

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 Results

• Ti-bond has superiority in mechanical properties than PEEK

• Minimum load is required to fail the implant-bone interface with low stiffness for PEEK

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 Results

• Table shows cortical and cancellous histomorphometry which quantified the percentage of contact between implant and
the bone
• Complete implant and bone contact equates to 1 and no contact equates to a value of 0
• Ti-bond outperformed at PEEK both 4 and 12 weeks
• Mean outgrowth for PEEK at 4 and 12 weeks revealed no increase with time
• There is minimal improvement in the direct bone contact for the PEEK implants

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 Critique
• Loading conditions were simplified due to the nature of the implantation
sites
• The statistical analysis methods were not clearly defined
• Use of pictorial views like bar chats and histograms would allow for
better demonstration of the results
• Pictorial views of the methodology are lacking
• The study does not maintain the change in other properties of PEEK like
chemical and thermal properties after addition of the plasma-spray
coating

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 Summary and Conclusion
• Bony ingrowth or ongrowth to implants provides a biological means to
achieve implant fixation
• The plasma-sprayed titanium coating used transformed the inert PEEK
to one that is capable of providing early bone ongrowth
• Titanium coating improved the shear strength at the bone-implant
interface and continued to improve with time compared to PEEK
• Despite the hydrophobic nature of PEEK, direct implant bonding can be
achieved by using a plasma-sprayed titanium coating
• Therefore, the application of surface topography or coatings to metal
substrates improves biological implant fixation, through bony ingrowth
or ongrowth
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