PEEK or polyetheretherketone is a high-performance, engineered plastic. It is one of the materials of choice medical implants such as spinal replacement disks as well as trauma fixation. Trauma fixation is the repair of broken bones or any bodily injury that can result from force or violence applied to the human body. It is also used for cardiovascular implants as well as in orthopedic surgery and dentistry. While in the past, metals such as titanium have often been used for this purpose, the polymer has taken the lead in many areas.
PEEK’s primary medical use has been in spinal implantation. It has been used for many years in this application and has been proven safe and effective. Patients with spinal stenosis, degenerative spondylolisthesis, degenerative disk disease, degenerative scoliosis, and other diseases of the spine have experienced relief from the implantation of PEEK spinal cages or spacers.
The optimal modulus of PEEK closely matches that of cortical bone which is the shaft of a bone that is around the marrow cavity. Its optimal modulus ensures the medical implant bears weight like a natural bone thereby making it less likely the the nearby bone suffers from density loss. The optimal modulus also helps prevent subsidence which is the sinking or settling in a bone for example in a prosthetic component of a total joint implant.
It also has radiolucency which is the capability of a substance to allow a large number of x-rays to pass through thus producing darkened images on x-ray films. Radiolucency permits a surgeon to better monitor the healing progress following a surgical procedure.
Trauma Fixation: Internal And External
These devices are put into the body and are used to maintain the shape and bearing load of a broken bone. These devices include cannulated screws, intramedullary nails, hip screws as well as pins, and bone plates. These fixation devices must be biologically inert. PEEK meets that requirement.
Also, hardware implanted in the body must provide excellent support for as long as the treatment requires. Hardware such as PEEK bone plates provides superior fatigue strength when compared to metals like stainless steel. The material offers optimum flexibility and stiffness, so it does not get in the way of the body’s own healing process. And should the medical implants need to be taken out, unmodified PEEK implants can be removed more easily than those made of metal due to less bone on-growth. Here again, its radiolucency allows the surgeon to better track the healing process. PEEK is also lighter than metals and allows patients to move their joints and limbs more easily.
External fixation devices are some of the oldest medical devices known. Hippocrates described external fixation methods used to treat a tibia fracture. External fixation devices pierce the dermis and using parts such as bolts, and wires to secure it to the underlying bone. This procedure is often performed when open fractures are present or if the injury must be temporarily stabilized prior to surgery.
PEEK plays an important role in heart surgery. Less Invasive Ventricular Enhancement or LIVE is a procedure used to correct the heart after myocardial infarction. It is often better than another procedure known as Surgical Ventricular Restoration or SVR. The heart must be stopped during an SVR, and the surgeon must also make several very precise incisions. In a LIVE procedure, the heart does not need to be stopped. Two anchors are positioned over the left ventricle and are tied together with a PEEK tether. This stabilizes the ventricle and allows the heart to function.
This material works well in orthopedic applications like knee and hip surgery for many of the same reasons it is used in trauma fixation. PEEK has an optimal modulus similar to the bone so the joint will bear weight and move like bone. As mentioned above, PEEK is radiolucent. And PEEK is lighter in weight than metals so patients can move more easily.
PEEK has long been used in the field of dental implants. Most often it is used to make partial dentures. Polyetheretherktone has excellent abrasion and compressive resistance and can handle chewing and tearing motions well. PEEK dental implants don’t affect taste. Patients report that PEEK dental implants are comfortable and are not likely to cause allergic reactions or sores. Additionally, these can be made to look like natural teeth.
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