How Long Has Peek Been Used For Shoulder Repair

Artful cranioplasty

Manas Nigam , ... Stephen B. Baker , in Aesthetic Surgery of the Facial Skeleton, 2022

Polyetheretherketone

Polyetheretherketone (PEEK), beginning described in cranioplasty by Hanasono et al., has gained popularity since the early 2000s. ¹⁵ ^, ¹⁶ It is chemically inert and has strength and elastic holding similar to cortical bone but without the disadvantages of titanium or PMMA. Dissimilar porous high-density polyethylene, PEEK maintains course when heated to greater than 300°C. VSP with CAD/CAM works well with PEEK and thus it tin exist used for a variety of defect configurations. PEEK has been shown to event in lower complication rates compared with other alloplastic and autologous approaches, but long-term data are lacking, given its recent introduction. Because of PEEK'south stiffness, intraoperative contouring is hard then minor intraoperative modifications may be difficult.

Read total chapter

URL:

https://www.sciencedirect.com/scientific discipline/article/pii/B9780323484107000393

Book 1

Ohan South. Manoukian , ... Sangamesh Chiliad. Kumbar , in Encyclopedia of Biomedical Engineering, 2022

Polyetheretherketone

Polyetheretherketone (PEEK) is a thermoplastic polymer that was commercialized in the early on 1980s and later proposed as a material to be used for medical applications ( Panayotov et al., 2022). Typically PEEK composite materials have been used as a replacement for metal and ceramic implants, which have a higher modulus of elasticity (Kurtz and Devine, 2007). PEEK was first introduced to the medical field equally a fracture fixation, and it remains to be used for this purpose. Despite several years and advancements, PEEK is still one of the most popular biomaterials on the marketplace due to its versatile capabilities (Manoukian et al., 2022b).

The chemic stability of PEEK has been of interest to medical device companies since its introduction in 1998. At room temperature, the simply solvent capable of dissolving PEEK is 98% sulfuric acid (Ferguson et al., 2006). Its modulus of elasticity is nearly identical to cortical os, which allows it to be an optimal candidate for an interbody device in vertebral fusion applications. Furthermore, PEEK is highly resistant to gamma and electron axle radiation, which allows for like shooting fish in a barrel sterilization. The costless radicals, which are produced from these sterilization methods, accept a life bridge of about 20 min. Due to this short lifetime, PEEK will not be considered as a source of secondary electron emission. PEEK is readily visible under MRI because of its natural radiolucency (Johansson et al., 2022).

PEEK has been incorporated into numerous practices such every bit dental reconstruction, spinal surgery, and many others as shown in Fig. 25. A major drawback often observed with titanium and titanium alloy implants is stress shielding. Due to the pregnant difference in elastic modulus between titanium and bone the strains that they confront when stresses are applied are dissimilar. This can cause os loss and ultimately implant failure. Recently PEEK has been proposed every bit an alternative because of its favorable elastic modulus (Fig. 26). Notwithstanding, PEEK does non have a high resistance to mechanical force which means it would need to undergo modifications to better conform the desired functionality. PEEK has also been proposed as the implant material for vertebral fusion surgery since its stiffness is similar to os and will allow the graft to heal uniformly. In addition, PEEK is radiolucent which volition let the doc to ensure that the implant is properly positioned for optimal healing.

Read full affiliate

URL:

https://www.sciencedirect.com/scientific discipline/commodity/pii/B9780128012383640989

Volume 2

Weihong Jin , Paul One thousand. Chu , in Encyclopedia of Biomedical Engineering, 2022

Polyetheretherketone

PEEK is a member of the polyaryletherketone (PAEK) family consisting of an aromatic molecular backbone with combinations of ketone and ether functional groups between the aryl rings. Ii members of the PAEK families considered for implants are polyetherketone and PEKK with the latter being ascendant in implants (Kurtz, 2022). PEEK is a polyaromatic semicrystalline thermoplastic polymer equanimous of a crystalline phase and an amorphous phase. The typical crystalline content of injection-molded biomedical PEEK ranges from 30 to 35%, which has a close relationship with the mechanical properties. The stabilized chemic structure of PEEK confers its stability at high temperature, resistance to chemical and irradiation deposition, and higher force than many metals. PEEK is extremely resistant to set on by all substances apart from concentrated sulfuric acid and is likewise biocompatible. Thermal degradation is not a concern for PEEK during clinical applications. Unlike UHMWPE, PEEK has notable resistance against gamma and electron beam irradiation, and the implant components can be effectively sterilized by gamma irradiation in air without degradation of the mechanical properties. The chemic inertness, biocompatibility, mechanical properties, and radiolucency render PEEK suitable biomaterials in orthopedic implants (Kurtz, 2022).

In the 1990s, PEEK emerged as a leading thermoplastic candidate as a substitution for metals in orthopedic implants. Although PEEK-based biomaterials are now widely accepted in the spine field, they proceed to be clinically investigated as hip stems and articular bearing components in joint prostheses and fracture fixation devices (Kurtz and Devine, 2007). PEEK composites have been developed by adding certain additives to enhance the strength and stiffness. Among the various additives, carbon and glass fillers were beginning used as reinforcement additives in PEEK, and carbon-cobweb-reinforced PEEK (CFR-PEEK) is currently studied as components in orthopedic implants (Li et al., 2022). The forcefulness and elastic modulus of the CFR-PEEK blended depend on the percent, size, length, and orientation of the fibers. Young's modulus of PEEK is iii–four GPa, which is about but not identical to that of the human os. With increasing percent of carbon fibers, Young's modulus and tensile force rise, but the elongation at intermission decreases, indicating that more robust PEEK is obtained. The CFR-PEEK composite with a certain composition may take mechanical strength and elasticity close to those of cortical os, thus providing support and minimizing the stress-shielding effect in fracture fixation applications. The CFR-PEEK composite also has first-class fatigue resistance, wear resistance, and durability making them suitable for long-term joint implants. No adverse side effects take been observed from PEEK, simply it is all the same considered bioinert because of the slow reaction with surrounding tissues. To overcome this trouble, increasing efforts have been made to raise bone growth around the implants to improve fixation of PEEK components with os by incorporating bioactive materials such as hydroxyapatite and Ti dioxide as a filler or applying a surface blanket on PEEK (Abdullah et al., 2022). Overall, the short-term constructive performance of the PEEK composites equally orthopedic implants is supported by preliminary clinical data. However, long-term clinical trials should exist done to prove the superiority over traditional orthopedic materials.

Read total chapter

URL:

https://www.sciencedirect.com/science/article/pii/B9780128012383109997

Technological advances for polymers in active implantable medical devices

Negin Amanat Maddock , ... James F. Patrick , in The Design and Manufacture of Medical Devices, 2022

Polyetheretherketone (PEEK)

PEEK is a loftier performance semi-crystalline engineering science thermoplastic. PEEK's well-nigh meaning desirable property is its exceptional thermal stability; with glass transition and melting temperatures of 143 °C and 343 °C, respectively. Information technology has a maximum continuous utilize temperature of 240 °C (without impact) and 180 °C (with impact) (Victrex, 2008). PEEK as well has superior chemical stability, allowing it to undergo repeated sterilizations. These robust backdrop, in addition to its high strength properties, have made PEEK a textile of choice for a number of applications in the orthopedic field. PEEK has been successfully used equally an implant fabric since the late 1990s, with ane of its earliest applications existence spinal spacers for support of vertebrae after spinal disk removal (Lamontagne, 2022). PEEK is now an established cloth pick for joint replacement, orthopedic trauma applications and cranio-maxillofacial applications (Jarman-Smith, 2008). Interest has expanded into farther areas, such as the AIMD sector. The Eon® Rechargeable nerve stimulator, as discussed in the previous section, uses PEEK to enable transcutaneous recharging of its power source (Sereno, 2010). PEEK has been investigated as a potential substrate for implantable electrodes and flexible circuits (Sereno, 2010). Flexible printed circuit boards (FPC) are significantly lighter than rigid printed excursion boards, just a fundamental challenge when using polymer substrates with metalized coatings is the divergence between the thermal expansion properties of metals and polymers. PEEK's coefficient of thermal expansion is double that of polyimide (PI), the polymer that is the conventionally used substrate for FPC. Consequently, Seidel and Muenstedt (2008) investigated incorporation of calcium carbonate and talc fillers to reduce PEEK's coefficient of thermal expansion. They found that the coefficient of thermal expansion for PEEK could exist reduced to values similar to that of the copper metalization, by using the talc filler at 30 wt.%. In add-on, as an alternative substrate for FPC to PI, PEEK offers similar thermal stability to PI, with superior chemical stability (confronting alkaline media) and substantially lower h2o assimilation than PI.

Read full chapter

URL:

https://world wide web.sciencedirect.com/science/article/pii/B9781907568725500078

Tribology of advanced composites/biocomposites materials

1000. Sharma , ... S. Shannigrahi , in Biomedical Composites (2d Edition), 2022

17.3.1 Polyetheretherketone biomaterials/biocomposites

Poly ether ether ketone (PEEK) has been increasingly employed as biomaterials for prosthesis, orthopaedic, and spinal implants. PEEK is a high functioning semicrystalline polymer having density of i.32 g/cm³; known for its outstanding thermal stability, mechanical properties, wear-resistance, and chemical resistance (even at elevated temperature) and high resistance to hydrolysis. PEEK has a T _g of 143°C and T _thou of 343°C. In improver, PEEK has fantabulous fatigue and creep resistance backdrop, flammability rating and low emission of smoke and toxic gasses during combustion, electric properties over a wide range of frequency and temperature, inherently pure polymer with uncommonly depression level of extractable ionic species, and outgassing and resistance to wearable and abrasion with good load bearing characteristics.

PEEK as biomaterial has received allure due to its abovementioned favourable characteristics. Although, its processing is intricate because of the high processing temperature and inertness to about of the solvents, it can exist processed by conventional sintering and hot melting process or past using powder prepreg methods when used with bidirectional fibrous reinforcements. Recent enquiry and evolution have suggested PEEK to be an alternative to metallic biomaterials in the spin replacement, hip joint, genu replacement, and other prosthesis applications. For mature fields such as total articulation replacements and fracture fixation implants, radiolucency is an attractive merely not necessarily critical material feature (Wenz et al., 1990; Morrison et al., 1995; Cook and Rust-Dawicki, 1995; Lin et al., 1997; Katzer et al., 2002).

Read full chapter

URL:

https://www.sciencedirect.com/science/article/pii/B9780081007525000184

Reconstruction of Full-Thickness Frontocranial Defects

South. Anthony Wolfe , Mark W. Stalder , in Facial Trauma Surgery, 2022

Polyetheretherketone (PEEK)

Polyetheretherketone (PEEK) is biocompatible, inert, and reported to accept similar mechanical backdrop to bone. Importantly, information technology can be formed to precisely fit frontocranial defects preoperatively based off 3-dimensional CT scans. For these reasons PEEK has been growing in popularity, based on the arguments that these implants save operative time, prevent donor site morbidity, and issue in improved artful outcomes. While early results seem to point better outcomes relative to other alloplastic materials, clinical series are limited in scope (betwixt five and 38 patients), and follow-up times are probably inadequate at this bespeak (from six to 24 months) to provide an accurate representation of the potential for long-term success. ^9–13 At that place does appear to be an implant failure rate of upwardly to 27% reported with PEEK, typically due to exposure and/or infection. ^9,10,12,14 A few directly comparison studies with PEEK cranioplasties have suggested a lower complication charge per unit relative to autogenous bone, nonetheless these were small series with brusk follow-up times, and this was clearly non consequent with our experience. ¹⁵

Read total chapter

URL:

https://www.sciencedirect.com/scientific discipline/article/pii/B9780323497558000359

The Biochemistry of Spinal Implants

Shawn Hermenau , ... Ravi Ramachandran , in The Comprehensive Treatment of the Crumbling Spine, 2022

PEEK

Polyether ether ketone (PEEK) is an organic polymer thermoplastic. Molecularly, it consists of phenylene rings that are linked via oxygen bridges. There have been no reports of biologic adverse response/reaction with this fabric. The plastic is used either alone or with a carbon cobweb reinforcement. It is a member of the polyaryletherketone family, which includes several other polymers with applications in spine surgery.

The showtime utilization of PEEK was in spinal cages in the 1990s, by AcroMed. An advantage of the polymer in this function is its radiolucency, which facilitates radiographic cess of fusion in vivo. The majority of current implants employing PEEK are cervical and lumbar spinal cages. Examples include Zimmer Spine'due south BAK Vista radiolucent Interbody Fusion System, Surgicraft's STALIF inductive lumbar fusion muzzle, Scient'x's CC interbody fusion muzzle, Depuy Spine's OCELOT Stackable Cage System, and the Nubac Disc Arthroplasty Device.

Recent studies with PEEK cages effort to accelerate fusion by incorporating hydroxyapatite, 40% β-tricalcium phosphate/60% hydroxyapatite, or rhBMP-two. Possible applications for the fabric in posterior dynamic stabilization, interspinous process decompression systems, posterior rods, and total disc replacement are too existence explored.

Read total chapter

URL:

https://www.sciencedirect.com/science/article/pii/B9781437703733100703

Periodontal and Maintenance Complications

Jon B. Suzuki , Carl E. Misch , in Misch's Fugitive Complications in Oral Implantology, 2022

Ultrasonic devices.

Ultrasonic devices with special polyetheretherketone-coated tips take been used to debride the implant surface. This tip is fabricated of a plastic textile with a stainless steel core. This ultrasonic device allows the debridement of plaque and calculus while leaving a polish and clean surface.

While metal tips are not recommended, plastic tips may have loftier chances of shredding when cleaning around implant grooves and threads. Tips made of PEEK material by Hu-Friedy have been shown to be resistant to shredding and may be considered.

Neither the American Dental Association nor American Academy of Periodontology have released a consensus on the use of ultrasonic devices around implants. Show is currently anecdotal and non sufficient to support use of devices.

Read total chapter

URL:

https://www.sciencedirect.com/scientific discipline/article/pii/B9780323375801000184

Polycondensation

R. Guo , J.E. McGrath , in Polymer Scientific discipline: A Comprehensive Reference, 2022

5.17.iii.2.i Sulfonated poly(arylene ether ketone)s

Sulfonated PAEKs, particularly sulfonated PEEK (SPEEK), take attracted much attention recently in the applications of proton commutation membrane fuel cells (PEMFCs) due to their good backdrop under fuel cell conditions. Sulfonation enhances the acerbity and hydrophilicity of PAEKs, which facilitates proton conduction in the presence of water. At 100% sulfonation, SPEEK tin can dissolve in water implying its loftier hydrophilicity. ¹⁵⁹

In concentrated sulfuric acrid solution (99–100%), PEEK was sulfonated to an equilibrium degree of one –SO₃H per structural repeat unit inside less than ane day. ^160,161 The resulting sulfonated polymer structures were confirmed past Fourier transform infrared (FTIR) and nuclear magnetic resonance (NMR) spectroscopies, as was the quantitative increment in molecular weight. In addition, sulfonation was found to occur exclusively on the phenyl rings, which are surrounded past the ii ether linkages ( Figure 37 ). The other phenyl rings were deactivated by the neighboring ketones. This statement is too supported by the observation that PEK molecules remained unsulfonated under the same weather condition since no activated phenyl rings were available for sulfonation.

Other than the usually known concentrated sulfuric acid, chlorosulfonic acid, pure or complexed sulfur trioxide, acetyl sulfate, and methane sulfonic acid ^{160,162–164} accept been shown to sulfonate PEEK effectively. Sulfonated polymers tin be prepared in various forms depending on different sulfonation method, such every bit costless acrid form (–And so_iiiH), salt form $({- SO}_{3}^{-} {Na}^{+})$ , esters (–And then_iiR), and diverse derivatives. Information technology has been shown that sulfonation is greatly hindered with decreasing ether group content in the PEK concatenation, that is, the ease of sulfonation follows the order of: PEEK > PEEKK/PEK > PEKEKK. ¹⁶⁵ However, information technology is difficult in most cases to achieve degrees of sulfonation (DS) greater than i.0 per repeat unit due to insolubility and side reactions such as interchain crosslinking and degradation. Marvel et al. ^166,167 reported that extensive degradation and crosslinking of the polymers occurred when sulfur trioxide–triethyl phosphate complex was used equally sulfonating amanuensis. Chlorosulfonic acrid was more satisfactory, but some degradation nonetheless occurred. Sulfonation of PEEK in H₂SO₄ (< 100%) is considered to exist low in degradation and crosslinking reactions. It has been suggested that the presence of water decomposes pyrosulphonate intermediates to inter- and intramolecular sulfone crosslinks. In full general, the DS of PEEK (xxx–100%) tin be controlled past the reaction time and temperature. Some polyetherketones, such every bit PEEKK and PEEK, can exist functionalized past electrophilic sulfonation with sulfuric acrid and were at 1 point commercialized by Hoechst-Aventis.

The sulfonated ionic PEEKs showroom modified properties from original PEEKs. For case, sulfonation alters the nature of concatenation packing, thus drastically reduces the crystallizability of PEEKs. However, T _g increases with sulfonation due to increased intermolecular interactions. With a DS of 0.72 (the concentration of –Then_threeH group per echo unit of PEEK), a fully amorphous polymer with a high T _g of 206 °C was obtained, ¹⁶¹ which was more than 60 degrees higher than the unsulfonated PEEK. Information technology was as well found out that sulfonation decreased the thermo-oxidative stability of PEEK significantly and that poorer melt processibility as well resulted. In recent research, ^168–172 information technology has been shown that SPEEK is promising for fuel cell applications (both direct methanol fuel cell (DMFC) and PEMFC) every bit it possesses adept thermal stability, mechanical strength, and adequate conductivity.

Read full chapter

URL:

https://world wide web.sciencedirect.com/scientific discipline/commodity/pii/B9780444533494001539

Ceramics for joint replacement

Corrado Piconi , in Advances in Ceramic Biomaterials, 2022

Abbreviations

ATZ: alumina-toughened zirconia
CFR-PEEK: carbon fiber reinforced PEEK
CoC: ceramic-on-ceramic
CoP: ceramic-on-polyethylene
DLC: diamond-like carbon
HIP: hot isostatic pressing
LPS: liquid phase sintering
Mg-PSZ: magnesia-partially stabilized zirconia
PEEK: polyetheretherketone
PSZ: partially stabilized zirconia
PTFE: polytetrafluoroethylene
RBSN: reaction bonded silicon nitride
ROM: range of motion
S6A: strontium exaluminate
THR: total hip replacement
TKR: total articulatio genus replacement
TZP: tetragonal zirconia polycrystal
UHMWPE: ultra-high molecular weight polyethylene
Y-TZP: yttria-stabilized tetragonal zirconia polycrystals
ZPTA: zirconia- and platelets-toughened alumina
ZTA: zirconia-toughened alumina
ZTCs: zirconia-toughened ceramics

Read full chapter

URL:

https://world wide web.sciencedirect.com/science/article/pii/B9780081008812000051