Biologic responses to polyetheretherketone (PEEK) wear particles
- Publisher:
- Elsevier
- Publication Type:
- Chapter
- Citation:
- PEEK Biomaterials Handbook, 2019, 2nd Edition, pp. 367 - 384
- Issue Date:
- 2019-03-08
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| Filename | Description | Size | |||
|---|---|---|---|---|---|
| Tipper PEEK Handbook Chapter accepted.pdf | Accepted Manuscript version | 237.67 kB |
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The biological response to wear particles is associated with failure and decreased longevity of total joint replacements. Particles in the size range of 0.1–10 μm are considered the most biologically reactive, particularly submicron-sized polymer particles. In bulk form, polyetheretherketone (PEEK) composites are generally considered to be biocompatible. In particulate form, however, the biological response remains unclear, with limited in vitro and in vivo studies defining the cellular reactions to particulates. Only three studies to date have analyzed retrieved periprosthetic human tissue samples to characterize the response to PEEK wear particles. In one study, PEEK particles were observed within macrophages, however, multinucleated giant cells were not present. In two other studies, rod-like carbon particulates and granular-shaped PEEK particles were identified in human tissue by histological analysis. A number of studies have quantified PEEK particles produced from PEEK bearings in joint replacement simulators. The mean particle size (i.e., Feret’s diameter) was reported to be between 0.23 and 2.0 μm, with a range of 0.01–50 μm. In vivo the biological response to PEEK-based particles was reported to be similar to ultrahigh-molecular-weight polyethylene (UHMWPE) particles. Inflammatory cytokine release [e.g., tumor necrosis factor-alpha (TNF)-α] was identified in more than one study without affecting macrophage viability. Only one study has investigated the effects of particle size on cytotoxicity and cytokine release and found unfilled PEEK particles (~ 13 μm) to have a toxic effect; UHMWPE particles in the same size range showed a similar cytotoxic effect. Further research is required to isolate and characterize PEEK-based particles from retrieved human tissue and, to elucidate the effect of particle characteristics, size, and dose on the biological response in both spinal and synovial joint models.
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