Facile Amidogen Bio‐Activation Method Can Boost the Soft Tissue Integration on 3D Printed Poly–Ether–Ether–Ketone Interface

Abstract

materials, bio-medicals, mechanics, and chemistry. Recently, the most commercialized artificial bone, titanium alloy based artificial bone, has been widely used in spine surgery, dental surgery, and thoracic surgery. [2][3][4] However, artificial bone with better biocompatibility, mechanical strength, and superior radiography properties is still desired. [5] Polyether-ether-ketone (PEEK) based artificial bone attracted tremendous interests due to its similar elastic modulus compared to that of cortical bone, [6][7][8] compatibility to radioluscent and magnetic resonance imaging [5,9] and chemical stability. [9][10][11] Therefore, PEEK has been extensively investigated and successfully used in spinal fusion, trauma, neurosurgical and craniomaxillofacial procedures, dental operation, joint replacements, and anterior cruciate ligaments repair. [12,13] Combining with 3D printing (3DP) technology, skeletal and individual PEEK implants were made to repair the chest wall defect in our previous studies. [5,[14][15][16] Up to now, more than 100 3DP PEEK implants have been used in our hospital. Unfortunately, some side effects of PEEK implants have been gradually realized in several years after clinical practices. The most happened cases are unsatisfactory cellular response and poor integration among the implants and Poly-ether-ether-ketone (PEEK) implants with good mechanical properties and chemical inertia, meet the urgent needs of bone substitute. However, its inert interface leads to poor soft tissue integration, which prolongs healing time of surgical incision with many complications. Herein, (3-aminopropyl) triethoxysilane is connected to 3D printed (3DP) PEEK interface by chemical modification. The homogeneous amino groups on amidogen interface enhance PEEK's hydrophilicity and proteinophilia significantly. Fibroblasts cultured on the amidogen PEEK interface show much stronger potential of cell adhesion and migration. Furthermore, soft tissue ingrowth into 3DP PEEK scaffold occurs more and faster in the amidogen interface in vivo. The observation of the microstructure shows tighter implant-tissue bonding interfaces on the amidogen PEEK. To mimic real surgery, 3DP PEEK implants of the same proportions in clinical practice are used to reconstruct the chest wall defects of rabbits. A significant reduction in healing time and incision complications are observed in the amidogen PEEK groups. In addition, 19 related proteins are found in the fibroblasts cultured on the amidogen PEEK interface, which can be used to trace the biological mechanisms. In all, the facile amidogen bio-activation method can significantly boost the soft tissue integration on 3DP PEEK interface with less surgical complications.

Poly (Ether-Ether-Ketone) for Biomedical Applications: From Enhancing Bioactivity to Reinforced-Bioactive Composites—An Overview

“…The addition of amine groups into PEEK is a powerful method to promote bioactivity since it serves as a base for the covalent immobilization of the cell-adhesive protein fibronectin. Liu et al [ 72 ] introduced amino groups into PEEK using (3-aminopropyl) tri-ethoxy silane as an amination agent. The study showed enhanced hydrophilicity and fibronectin adsorption on the aminated PEEK.…”

Current surface modification strategies to improve the binding efficiency of emerging biomaterial polyetheretherketone (PEEK) with bone and soft tissue: A literature review

“…After seven days of cell proliferation, the number of cells on the surface of the modified PEEK was significantly higher than that on the unmodified PEEK and Ti alloy. Liu et al [109] connected 3-aminopropyl triethoxysilane to a 3D printed PEEK surface via chemical modification. Uniform amino groups on the amidogen interface significantly enhanced the hydrophilicity and protein affinity of PEEK.…”

Fused Deposition Modeling PEEK Implants for Personalized Surgical Application: From Clinical Need to Biofabrication

“…Thus, enhancing the soft-tissue integration with the 3DP PEEK implant is the main method to reduce implant-related complications. We have developed surface amination grafting and sulfuric acid etching methods to increase the hydrophilic of 3DP PEEK implants[ 45 - 46 ].…”

“… Schematic diagram of FDM PEEK implant modification and animal experiment results (A); SEM images of the interface on amidogen PEEK (B); three-dimensional images of the interface on amidogen PEEK (C); the comparison of cellular proliferation in FDM PEEK, NPEEK scaffolds, and blank materials using CCK-8 method (D); the comparison of cell migration on NPEEK and PEEK interfaces using wound healing assay (E); HE staining and SEM images of soft-tissue ingrowth into the FDM PEEK and NPEEK scaffolds in vivo for 2 weeks (F); the clathrate PEEK or NPEEK implants and the rabbit after chest wall reconstruction surgery (G); the comparison of drainage fluid (H) and extubation time (I) after chest wall reconstruction surgery in FDM PEEK and NPEEK groups (* P < 0.05, ** P < 0.01 and *** P < 0.001)[ 46 ]. …”