Fracture fixation in extremity trauma with carbon fiber-reinforced polyetheretherketone (CFR-PEEK) plates: evidence today

Abstract

Purpose To compare the CFR-PEEK plates with conventional plates in fracture fixation with regards to clinical and radiological outcomes and complications. Methods A systematic literature search was conducted in four online databases independently by two reviewers using the Cochrane methodology for systematic reviews. The identified relevant studies were assessed against predetermined inclusion/exclusion criteria. Independent data extraction and assessment of risk of bias and study quality was carried out. Results Nine studies (patient n = 361) out of 6594 records were included for analysis: 2 RCTs (n = 63), 3 prospective cohort studies (n = 151), and 4 retrospective cohort studies (n = 147). Studies were grouped per anatomic area of fixation. Four studies (n = 200) examined fixation of proximal humerus fractures. Two studies (n = 74) examined fixation of distal radius fractures. Two studies (n = 53) assessed outcomes of fixation of distal femur fractures. One study (n = 87) assessed the outcomes of fixation of ankle fractures. All nine studies reported very high union rates (from 91% in distal femur to 100% in upper limb) for the CFR-PEEK plate groups and low complication rates. There was no significant difference in clinical outcomes, and rate of complications as compared to the conventional plate groups. Conclusion CFR-PEEK plates have high union rates in extremity fracture fixation similar to conventional plates with comparable good clinical outcomes and a very low and comparable rate of complications. Considering their advantages, CFR-PEEK plates seem to be valid alternative to conventional plating.

Low-Temperature Plasmas Improving Chemical and Cellular Properties of Poly (Ether Ether Ketone) Biomaterial for Biomineralization

“…PEEK applications in orthopedics continue to grow, with just a couple being in fracture fixation [ 24 , 25 , 26 ] and commercialized dental implants such as VESTAKEEP PEEK. PEEK is one of several polymers that has been investigated for scaffold application in BTE, some of which include PCL [ 27 , 28 ], Polyurethane [ 29 ], and PLA [ 30 , 31 , 32 ].…”

Carbon-fibre plates for traumatic and (impending) pathological fracture fixation: Where do we stand? A systematic review

“…Despite the increasing use of CF plates for fixating traumatic and (impending) pathological fractures, reported experience in the literature remains limited. Previous systematic reviews have primarily focused on comparative studies or specifically examined traumatic distal radius fracture fixation with CF plates [ 11 – 13 ]. In these studies, CF plates were considered as a valid alternative due to comparable results to metal plates [ 11 – 13 ].…”

“…Previous systematic reviews have primarily focused on comparative studies or specifically examined traumatic distal radius fracture fixation with CF plates [ 11 – 13 ]. In these studies, CF plates were considered as a valid alternative due to comparable results to metal plates [ 11 – 13 ]. However, cohort studies and case reports have identified several disadvantages associated with CF plates that were not mentioned in the aforementioned systematic reviews.…”

Response to letter: Carbon fibre reinforced PEEK versus traditional metallic implants for orthopaedic trauma surgery: A systematic review

“…We have had the pleasure of reviewing your work on the subject. 1 Overall there is no available moderate or high certainty evidence to support the use of CFR-PEEK (CFRP) implants. 2 We respectfully disagree that "all levels in the hierarchy of research methods (evidence pyramid) are inherently biased".…”

“…The data for this location only comprises 53 patients in total from comparative analyses which precludes robust assessment of implant effects. Although the proportion of open and periprosthetic fractures may be similar, there are so few in the CFRP arm and so many in the conventional arm it is quite plausible that these more complex fractures drove some of the estimates (Table 2 from Chloros et al 1 ). A CFRP plate can also introduce a substantially different rigidity and thus stress force across the implant and total knee arthroplasty (TKA) which may alter outcomes.…”